186578349-753 Bell St .pdf()V E L)'tlo �v
ROW PERMIT NO.: ENG
ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: 186578349
CONTRACTOR: PSE/Infrasource
Mailing Address: 1660 Park Lane, Burlington, WA 98233
StateLicense#: INFRASL871C2
City Business License #: NR-023614
CONTACT: Sue Sidick
Phone #: 425-457-6353
Fax 9:
Email #: Susan.Sidick@pse.com
F1 Liability Insurance E] Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 753 Bell St
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
F-1 Commercial F-1 Subdivision E] City Project E] Traffic Control (Only)
F-1 Multi -Family X Single Family F-1 Other
F-1 EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit9
� ANY ASSOCIATED PERMITS?
F-1 Yes F* No
BLD4 ENG4
DESCRIPTION OF PROPOSED WORK (Be Specific) : Work area is approx 2'S c/I of Bell St
& 112'W c/l of 8th AVE N . emergency gas leak repair follow up work has been completed 1 4x5 paving cut
� WAS STREET OVERLAYED WITHIN THE LAST FIVE (5) YEARS? YES El NO [I Year: 18651
PAVEMENT CUT:
CONCRETE CUT:
El Yes El No
El Yes El No
If yes, indicate size of cut: 3
If yes, indicate size of cut: —
x 5
X
RIGHT-OF-WAY
CLOSURE
AREA
I
TOTAL
DURATION
(NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF
X
LF
SF
Alley 72 Hrs + LF
X
LF
SF
Parking 72 Hrs + LIT
X
I
LF
I
SF
J
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 helshe 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.
Dpl.��y sp.d by S—, S,d,,k
DN � S". S,d,,k P,1111bl�g DP11t11111t M1111,P11
Susan Sidick "'11 "", � di,�@p�� — US 6/5/2018
SIGNATURED1b. 2018 06 05 10 58 37 07 00 DATE
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
PRt-INSPEdTION R5PORT
* PUCETSOUNDENEROY
.L)ate:
Address:
Jurisdlctfon: City / Zip:
Right of Way.Parmit?. YES No— Customer:
Est Start. Date: MST PHONE NUMBEq
Est. duration: PM I Insp: V e
�HOXRWMBER
WQRKDEB-CRIPTION-
El
&A)
T
-41
Work -Location Size of CU 'Surface mme_
N2*f CL
E40of CL ENS!: Ain, A3
'N S of CL, &_ 'E W of CL
IN S of-CL &_ 'E W of CIL
FLAGGERS MPH El TROLLY LINES Ej 13US STOP METER HO'ODS'#
orr-ic:ERs
El TRAFFic SIGNAL ARTERIAL
_NO PARKS #
Commercial Altered Commercial ap
:gR Leak R' atr SerVICe Infoii5tion
(9 Rfislde6tial E]- Altered Residential 0 CP Work Diameter Motor - EFV Pressure Template Bar
13 :,Multj-Fainl� El ReOlacement Ser'v'lce D Pothole S/8" 250 1800 El 6" El
Q New QP-tr- Ll Mal'n'MaIntenance E),ctenslon 1118' 425 2_�00. wc
n Siub': SeMce M , alnbpnance El 11/4" El 63o io,000 2# El Bollards 4�' #
El nd�Jon El Valvp Maintenance . [] 2" 1000 . �64 F1 FUEL LINE PERAIT NEEDED
E] E] �(),f&.Cap Mtr LOG: F . pel Line Length:
Fuel Line Dla�nater:
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 008997
Card Exp. 08/13/2019
gregory.harwood@pse.com
LEGEND I
f
28" TRAFFIC CONE
F�M
BORE PIT
=>
TRAFFIC FLOW
FLAGGER
WORK VEHICLE/
FLASHING LIGHTS
SIGN LOCATION
RIGHT OF WAY
ROW—
Row—
CHANNELIZATION
DEVICE SPACING
MPH
TAPER
TANGENT
55/70
40
80
35/45
30
60
25/30
20
40
I
§2
CD
BE
12 12 - BE
P p
REPARED
C) TO
STOP
R ROAD
OA 7
WORK CD
04
AHEAD ?�:
BELL ST
PUGET
SOUND
ENERGY
JOB# 186578349
753 Bell St Edmonds, WA
5/30/2018
stephen.gadke@pse.com
425-424-6431
SHEET 1 of 1
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 1 1'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 approx. 112'WCL of 8th Av N
& 12'SCL of S Bell St.
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No electric grid information available
Scale 1:528
S 160062, Q 163066
05-10-2018
Lat\Long=47.8114, -122.3701
PucErsouNDENERoy
0'"'0