20170405113736.pdfA 0
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
I? F911
*PERMIT MUST BE POSTr,,D ON JOBSITE*
STATUS: ISSUED ENG20170099
RIGHT OF WAY PERM IT (I -Sin le Family)
Pennit Number: ENG20170099 Expiration Date: 10/05/2017
Job Address: 820 MAPLE ST, EDMONDS Location: 820 Maple
CONTRACTOR
APPLICANT
Edmonds Remodel
Edmonds Remodel
GO Greg Brewer
C/O Greg Brexwr
PO Box 1692
PO Box 1692
Edmonds, WA 98020
Edmonds, WA 98020
(206) 227-1029
LICENSE #: EDMONRI972BG EXP: 02/08/2019
JOB DESCRIPTION
Remove and replace 25sf of concrete walkway at the front of the home at Maple St.
DISRUPTION INFORMATION
ASSESSED VALUE� $0 00 PROPERTY AREA: 0
SIDEWALK: (OXO) DURATION IN MONTHS: 0 FEE: WOO STREET DISRUPTION TRENCH CUT: 0 X 0
PARKING: OXO ) DURATION IN MONTHS: 0 FEE: $0 00 YEAR OF OVERLAY: 0 FEE: $0.00
ALLEY OX0 I DURATION IN MONTHS: 0 FEE: $0 00
INDEMNITY- The Applicant has signed an application ivhich states helshe holds the City ofEdmonds harmlessfrom injuries,
damages or claims ofany kind or description whalsoever, foreseen or unforeseen, that may be made against the City ofEdmonds or
any ofils departments or employees, including but not limited to the defense ofany legal proceedings including defense costs and
atiorneyfees by reason ofgranting thispermit.
THE C 0 NTRACTO R IS RESPO NSIBLE FO R W 0 RKMANSHIP AND NIATERIALS FO R A PERIO D 0 F 0 NE YEAR FO LLOW ING THE FINAL
INSPEC TIO N AND AC CEPTANC E 0 F THE W 0 RIC
• 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 cenification verifying completion of the required training in their
possesion.
• 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 pennit application.
CALL I)LkL-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 NOTAPERMITUNTIL SIGNED BY THE CITY ENGINEER OR HISMER DEPUTY: AND FEES ARE PAID, AND RECEIPTJS ACKNOWLEDGED IN
SPACEPROVIDED
Printed: Wednesdav, April 05. 2017
1�
BY
TE
E] FILE COPY F� INSPECTOR COPY 0 APPLICANT COPY
OV EDA4()�V
"AIC—.1 $90
PROJECT NAME:
ROW PERMIT NO.: ENG_7,12-10QA1
ISSUE DATE:
RIGHT-O&WAY CONSTRUCTION
PERMIT APPLICATION
CONTACT:
CONTRACTOR: - r-:�ZL�'n s Phone #: -20�, -Z�b-7 10 :141
Mailing Address: F6, -
State License #: tL) Q__53-7-7, r_5 (�-
City Business License #:- 13L �- oce-7,�3fo
Email #: w-w
_�Liability Insurance -0 Bondedl
ADDRESS OR INTERSECTION OF CONSTRUCTION:
FR_0W WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
F] Commercial El Subdivision El —City Project Traffic Control (Only)
�17 E C
Multi -Family -W] Single Family El Other
1%1,"�R 2 2017
EUC (PUD, VERIZON, PSE,
OPMENT SERVICFq
COMCAST, OVWSD):
Is this permit part of a blanket permit? 0 Yes R No
ANY ASSOCIATED PERMITS? BLD# -Z0/,60q`Z/ ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific):
I WAS STREET OVERLAYED WITHIN THE LAST FIVE (5) YEARS? YESE] NOEO ear: I
PAVEMENT CUT: 0 Yes No If yes, indicate size of cut:
CONCRETE CUT: El Yes No If yes, indicate size of cut:
x
x
RIGHT-OF-WAY
AREA
CLOSURE
TOTAL
DURATION
(NUMBER OF MONTHS)
I
Sidewalk 48 Hrs + LF
Alley 72 Hr: + LF
Parking 72 Hr + LF
X
LF1
LF
LF
SF
X
I x
SF
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 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.
SIGNATURE DATE
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
,-DMONDS REMODEL, I
RO.BOX 1692
EDMONDS, WA98020
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r-61 161101'�> CLAV-
N
bi 144
2009 Edition
Page 635
Figure 61-1-1. Work Beyond the Shoulder (TA-1)
I t
A
ROAD
WORK
AHEAD >
SNGINELAR"3 ICAOG"4
APP 0 AS NOTE �
14-2
Note: See Tables 6H-2 and 61-1-3 for the meaning
of the symbols and/or letter codes used in
this figure.
Typical Application 1
December 2009 Sect- 611.01