106344396-1125 Olympic Ave.pdfof E c)'tlo v�
jNC. 1890
ROW PERMIT NO.: ENG
ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: 106344396
CONTRACTOR: PSE/Infrasource
Mailing Address: 1660 Park Lane, Burlington, WA 98233
State License #: INFRASL871 C2
City Business License #: NR-023614
CONTACT: Sue Sidick
Phone #: 425-457-6353
Fax #:
Email #: Susan.Sidick@pse.com
❑ Liability Insurance ❑ Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 1125 Olympic Ave
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
❑ Commercial ❑ Subdivision ❑ City Project ❑ Traffic Control (Only)
❑ Multi -Family ❑X Single Family ❑ Other
❑ EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit9
ANY ASSOCIATED PERMITS?
❑ Yes ® No
BLD# ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) : Work area is approx 13' E c/I of Olympic Ave &
40' S c/I of Viewland Way . (2) 3x5 concrete cuts anticipated. Please rush no heat to install gas service
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES ❑ NO ❑ Year: 1063
PAVEMENT CUT:
CONCRETE CUT:
❑ Yes ❑ No
❑ Yes ❑ No
If yes, indicate size of cut: _
If yes, indicate size of cut: 3
RIGHT-OF-WAY
CLOSURE
AREA
TOTAL
DURATION
(NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF
X
LF
SF
Alley 72 Hrs + LF
X
LF
SF
Parking 72 Hrs + LF
X
LF
SF
APPLICANT TO READ AND SIGN
*Traffic control and public safety shall be in accordance with City regulations as required by the City
Engineer. Every flagger must be trained as required by (WAC) 296-155-305 and must have certification
verifying completion of the required training in their possession.
*Restoration is to be in accordance with City codes and Standards. All street -cut trench work shall be
patched with asphalt or City approved material prior to the end of the workday — NO EXCEPTIONS.
Indemnity: The Applicant has signed an application which states he/she hold the City of
Edmonds harmless from injuries, damages or claims of any kind or description
whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds or
any of its departments or employees, including defense costs and attorney fees by reason
of granting this permit.
I have read the above statements and understand the permit requirements and acknowledge that I must
follow all requirements in order for the permit to be valid.
Susan-1 1 - Digiie signed ,d Suse ,1111 /�/LO
I d I cK DN at=Susan 11 " ,=di,nitlin DepaNnUS ou=Muniapal
SIGNATURE D1b.201808��7064n=7 0700=e�nm �-Ds DATE
Deia: 2018.08 0] 08:43 2]-0]'00'
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Puget Sound Energy Gas Pre -Inspect Form
Job #:
106344396
Date:
8/3/18
Address:
1125 Olympic Ave
Jurisdiction:
Edmonds
City / Zip:
Edmonds, 98020
ROW Permit:
Yes
Customer:
Karen Cooper 425-750-7896
Est. Start Date:
Cycle C
PM / Inspector:
Jordan Cooper 425-623-5302
Est. Duration:
1-112 Days (12 hours)
Job Description / Scope of Work
From 2" MPE IP 13'S (186578344-2018) Run New Scat 1 1/8 PE Service 115' (30' Stub and 85' Ext)
New Construction:
No
and Set A250 Meter OR. 60' ROW. SEE ATTACHED CITY OF EDMONDS GIS MAP
Construction Method
All Scat / Trenchless
PLAT Map: 162067
I 1
. I
I I
N
I I
Viewland Way I I 1
— . — . — . — . — . — . — . _ . _ . _ . _ . _ . _ . _ . _ . _ — . — . — — - . _ . _ . -. . _ . _ . _
— — — — — — — — — — — — — — — — — — — — — — — — — — — — —- �—
I I
I
P I 11
'Gras
Or
o
I 11
I
Drivaway I I 11
1125 Olympic Ave
y
Drivaway
II
al
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PL II
8" Concrete I
6" DI Water 8" Concrete Storm.
Sewer I
I I II
1 I
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Work Location
Size of Cut
Surface Type
13'
E
of CL
10lympicAve
&
40'
1 S
I of CL
IViewland Way
3x5
C
13'
E
of CL
Oympic Ave
&
40'
S
I of CL
lViewland Way
3x5
C
Of CL
I
&
I of CL
Service Information
Street Information
Job Type
Diameter:
1-1/8" PE
Flaggers #:
Y
Arterial:
y
New Residential Svc
EFV:
1-1/8" - 2600 - 9999144
Police #:
N
TCP:
y
Tie -In Fitting
Meter:
A250
Speed Limit:
25
No Parks #:
y
Meter Loc:
08 - OR
Trolley Lines:
N
Mtr Hoods #:
N
Del Press:
6" W.C.
Traffic Signal:
N
Bus Stop:
N
Bollards:
2.5" # I N 1 4" # N
I ADA Ramps #:1
N
Route #'s:
I N
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 008997
Card Exp. 08/13/2019
gregory.harwood@pse.com
(425)424-6425
DEAD END
CHANNELIZATION
DEVICE SPACING
MPH TAPER TANGENT
55/70 40 80
35/45 30 60
25/30 20 40
CD
N
00' 1 100' 100'
`0
00
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DAm
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w20-4
Notes:
1. All signs and spacing to conform to the
MUTCD and City of Edmonds standards.
2. All sidewalks, driveways, exits and egresses
shall be completely clear unless otherwise indicated.
3. Channelizing devices are 28" traffic cones.
Use traffic drums (barrels) with steady burning
Type C lights on all State State Routes and Hwys.
4. Sign size can be a minimum of 36" x 36" and
shall not obstruct pedestrian access.
5. Crew is required to leave a minimum of 11' for
traveling lane width.
6. Alert affected residents and businesses.
7. Work to take place between 9 a.m. and 4 p.m
unless otherwise specified. All work for arterials
and major roadways will be from 9 a.m. to 3 p.m.
8. Work area will be Work area will be 13' ECL of
Olympic Av & approx. 40' SCL Of Viewland Way.
4 PUGET
SOUND
ENERGY
JOB# 106344396
1125 Olympic Av Edmonds
8/6/2018
stephen.gadke@pse.com
425-424-6431
SHEET 1 of 2
Ido
I
t
SIDEWALK T
CLOSED ry
i
FLAGGERS TO
ASSIST PEDESTRIANS
I
10110
b'4
a
0
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C=
ROAD
ROAD - 7
WORK N
4HEAD
LEGEND
®
28" TRAFFIC CONE
BORE PIT
TRAFFIC FLOW
FLAGGER
WORK VEHICLE/
FLASHING LIGHTS
SIGN LOCATION
RIGHT OF WAY
ROW ROW
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 008997
Card Exp. 08/13/2019
gregory.harwood@pse.com
(425)424-6425
o auow ii rninnnurn
DEAD END Nb ..••• '''
W20-1 W21-5
CHANNELIZATION
DEVICE SPACING
MPH TAPER TANGENT
55/70 40 80
35/45 30 60
25/30 20 40
Notes:
1. All signs and spacing to conform to the
MUTCD and City of Edmonds standards.
2. All sidewalks, driveways, exits and egresses
shall be completely clear unless otherwise indicated.
3. Channelizing devices are 28" traffic cones.
Use traffic drums (barrels) with steady burning
Type C lights on all State State Routes and Hwys.
4. Sign size can be a minimum of 36" x 36" and
shall not obstruct pedestrian access.
5. Crew is required to leave a minimum of 11' for
traveling lane width.
6. Alert affected residents and businesses.
7. Work to take place between 9 a.m. and 4 p.m
unless otherwise specified. All work for arterials
and major roadways will be from 9 a.m. to 3 p.m.
8. Work area will be Work area will be 13' WCL of
Olympic Av & approx. 40' SCL Of Viewland Way.
#1125
PUGET
� SOUND
ENERGY
JOB# 106344396
1125 Olympic Av Edmonds
8/6/2018
stephen.gadke@pse.com
425-424-6431
SHEET 2 of 2
o - --