20170616145821.pdfk.1TY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBS1TE*
STATUS: ISSUED ENG20160472
RIGHT OF WAI'PERM IT (3-Commercial)
Permit Number:+ENG20160472 Expiration Date: 12/16/2017
Job Address: 9227 OLYMPIC VIEW DR, EDMONDS Location`.
APPLICANT CONTRACTOR
C-10 CHRIS DEVOIST 19240 DES MIONES MEMORIAL DR
918 S'HORTON ST STE 300
STE 1002 SEATAC, WA 98148
SEATTLE, WA 98134 (206) 253-1941
LICENSE # GENERDI927CG.. EXP: 02/07/2018
REPLACE TWO EXISTING ANTENNASAND ANCILLARY EQUIPMENT AND ADD 2'ANTENNAS AND ANCILLARY
EQUIPMENT ON EXISTING WIRELESS FACILITY ON AN EXISTING UTILITY POLE IN THE RIGHT OF WAY
DISRIPTION INFORMATION
ASSESSED VALUE: $0,00 PROPERTY AREA 0
SIDEWALK: (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: ( OXO) DURATION IN MONTHS: 0 FEE, $0,00
INDEMNITY 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 be made against the City of Edmonds or
any ofits 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'RESPONSIBLEFOR WORKMANSHIP AND MATERIALS FORA PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND AC CEPTANCE O F THE W ORtC
• 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
posseson.
• 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
TION IS NOTAPERMITUNnL SIGNED BY
❑ FILE COPY
SPACE PROVIDED,;
INSPECTOR COPY
❑ APPLICANT COPY
IN
• Restore ROW to City standards
• Restore Landscape to like or better conditions.
• Call for locates of underground utilities prior to any, excavation.
• Alert affected residents and/or businesses prior to work start.
• Conform to approved working drawings and Traffic Control plan.
• Public utilities maintain 5' separation from City Utilities.
• Verify clear bore crossings
• Utility patch restorationto be in accordance with Edmonds Standard detail E2.3
• Maintain erosion&sedimentation control. Keep street clean,
• Call for required inspections as noted.
• Traffic Control per approved plan and MUTCD. Refer to City of Edmonds traffic control requirements.
• Applicant shall repair/replace all damage to utilities or frontage improvements in City right-of-way per City standards that is
caused by or occurs during the permitted project.
• Sound/Noise originating from temporary construction sites as a result of construction activity are exempt from the noise limits
of ECC Chapter 5.30 only during the hours of 7:00am to 6:OOpm on weekdays and 110:00am and'6:OOpm on Saturdays, excluding
Sundays and Federal Holidays. At all other times the noise` originating from construction sites/activities must comply with the
noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120.
• Applicant, on behalf of his or her spouse, heirs, assigns, and successors in interests, agrees to indenmify defend and hold
harmless the City of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of
whatever nature, arising, directly or indirectly from the issuance of this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirements of any City ordinance not limit in any way the City's ability to enforce any ordinance
provision.
INSPECTIONS
• E-Traffic Control
• E-Curb/Otter Pre -Pour
• 11Sidewalk Pre -Pour
•- E-Driveway Form & Slope Ver„
• E-Pavement Subgrade
• E-Engineering Final'
PARTIAL INSPECTION DATE: INITIAL: NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTES:
FINAL INSPECTION' APPROVED DATES tNIT[A L
OF EDtilr-),
RECEIVED
MAY 2 6 2017 ROW PERMIT NO.: ENG kltn02
ENGINEERING DIVISION
ISSUE DATE:
RIGHT-OF-WAY CONSTRUCT"ION
EMIT APPLICATION Chris DeVoist- Ryka Consulting
5628 Airport Way South Suite 112, Seattle, WA 98108
PROJECT NAME: AT&T SN77 EDMONDS BEACH LTE 2C CONTACT:
CONTRACTOR: GENERAL DYNAMICS INFO TECH
Mailing Address:19240 Des Moines Memorial Dr Ste 300
State License #: GENERD1927CG
City Business License #: NR-022726
Phone #: 206-523-1941
Fax #: 206-260-7930
Email #: CDeVoist@rykaconsulting.com
Liability Insurance Ll Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: RIGHT OF WAY ADJACENT TO 9227 OLYMPIC VIEW DR
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE, OF PROJECT:
El Commercial 0 Subdivision El City Project 0 Traffic Control (Only)
❑ Multi -Family ❑ Single Family ❑ Other
] EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit? ❑ Yes [, No
ANY ASSOCIATED PERMITS? BLD# ......__- ENG# ..................
DESCRIPTION OF PROPOSED WORK (Be Specific) : AT&T PROPOSES TO REPLACE 2 EXISTING
ANTENNAS AND ASSOCIATED ANCILLARY EQUIPMENT AND ADD 2 ANTENNAS AND ANCILLARY EQUIPMENT
ON AN EXISTING WIRELESS FACILITY ON AN EXISTING UTILITY POLE IN THE RIGHT OF WAY.
WAS STREET OVERLAYED WITHIN THE LAST FIVE YEARS? YES D NO Year:
PAVEMENT CUT: ❑ Yes ❑ No
CONCRETE CUT: ❑ Yes ❑ No
If yes, indicate size of cut: z
If yes, indicate size of cut: x
R
IGHT-OF-WAY F-WAY DURATION
URE AREA TOTAL (NUMBER OF MONTHS)
k 48 Hrs + LF X LF SF
y 72 Hrs + LF X LF SF
g 72 Hrs + LF X LF SFIN
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 tlr ermit to be valid.
SIG:ATU... DATE
Contractor or Agent
NO WORK SIL I.,I, BEGIN PRIOR TO PERMIT ISSUANC"E