20160523084822.pdft
CITY OF EDMONDS,
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PE10W MUST BE POSTED ON JOBSI>
STATUS: ISSUED ENG20160119'
RIC.14T OF WAN! PERM IT (6-Et,JC)
Permit Number:'ENG20160119 Expiration Date: 11/23/2016
Job Address: 7600 212TH ST SW, EDMONDS Location: 76th and 212th
Frontier Communications PACIFIC CABLE
Attn: Shelley Haugstad 11321 HWY 99 S#10
1800 41st Street
Everett, WA 98201
LICENSE`# PACIFCC954PJ EXP: 10/18/2017
Lei 120
Audits of existing cables are required, this is preliminary workto be completed for City of Edmonds intersection improvement project.
Work proposed is in e)dsting vault east of the intersection.
DISRUPTION INFORMATION
ASSESSED VALUE: $0.,00 PROPERTY AREA: 0
SIDEWALK: i (OXO) DURATION IN MONTHS: 0 FEE: $0.00 STREET DISRUPTION TRENCH CUT: ( 0 X 0 )
PARKING ( OXO) DURATION IN MONTHS: 0 FEE: $0,,00 YEAR OF OVERLAY: 0 FEE: $0.,00
ALLEY: 0X0 ): DURATION IN MONTHS. 0 FEE: $0,00
IIVDEMATTY The Applicant has signed an application which states he/she holds the City of Edmonds harmless from injuries,
damages or claims ofany kind or description whatsoever, foreseen or unforeseen, that may made against the City of Edmonds or
any ofils departments or employees, including but not limited to the defense ofany legal proceedings including defense costs and
attorney fees by reason ofgranting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONEYEAR FOLLOWING THEFINAL
INSPECTION AND ACCEPTANCE OF THE W ORK.
• 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
posses ion.
• Restoration is to be in accordance with City codes. All street -cut trench work shall be patched with asphalt or City approved
material prior to the end of the workday -NO EXCEPTIONS.
• Three sets of construction drawings of proposed work are required with the permit application.
CALL DIAL A-DIG(1-800-424-5555) BEFORE ANY EXCAVATION
CALL FOR "'INSPECTION ;(425) 771-0220 EXT. 1326
24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQUESTS
THIS APPLICATION IS NOTA PERMIT UNTIL SIGNED BY THE CITY ENGINEER OR HISMERDEPUTY: AND FEES ARE PAID, AND RECEIPTIS ACKNOWLEDGED IN
SPACE PROVIDED.
Printed :Monda Ma` Z312016;
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RELEA BY ZATE
EJ FILE COPY INSPECTOR COPY APPLICANT COPY
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CHANNELIZING DEVICE SPACING (FT)
MPH
1
TANGENT
50/65
40
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3s74-5
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200" t
BUSINESS DISTRICTS
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