6.21.19 - Issued Permit ENG20190281.pdfED
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20190281
RIGHT OF WAY PERM IT (6-EtJC)
Permit Number: ENG20190281 Expiration Date: 12/21/2019
Job Address: 8609-244TH ST SW WF: Location: 8609-244th ST SW (Ref BLD20171333)
BLD20171333)
APPLICANT CONTRACTOR
OLYMPIC VIEW WATER & SEWER DISTRICT OLYMPIC VIEW WATER & SEWER DISTRICT
ATTN: LYNNE DANIELSON ATTN: LYNNE DANIELSON
8128 228th St SW 8128 228th St SW
EDMONDS, WA 98026 EDMONDS, WA 98026
(425) 774-7769
LICENSE 4: U131:312 000 543 EXP:
Phase 1: Potholing within sidewalk to verify water main location and connect (if within sidewalk), no cuts permitted to the asphalt street.
Phase 11 (After October Ist 2019, cuts permitted): Water main installation and connection. Sewer installation with manhole. All pipe
work to be installed per approved plans.
(Pavement cut 32x4 for sewer. 12" water main to be connected in eAsting sidewalk along east side of frontage, 6xg)
Cuts to the asphalt street mill require a minimum final restoration of 20'full lane width grind and overlay. Additional fees to be paid
depending on size of cuts, to be determined by city inspector.
DISRUPTION 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: OX0 DURATION IN MONTHS: 0 FEE: $0.00
INDEMATTY- The Applicant has signed an application which 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 this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OFONEYEAR FOLLOWING THEFINAL
INSPECTION AND ACCEPTANCE OF THEWORK.
• 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
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 permit application.
CALL DIALA-DIG (1-800-424-5555) BEFOREANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT. 1326
24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQUESTS
APPLICATIONAPPROVAI.
THIS APPLICATION IS NOTAPERMTUNTIL SIGNED BYTHE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPTIS ACKNOWLEDGED IN
SPACEPROVIDED.
Printed: Friday, June 21, 2019
El FILE COPY F-1 INS PECTOR COPY E] APPLICANT COPY
STATUS: ISSUED
ENG20190281
• 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.
• Utility patch restoration to be in accordance with Edmonds Standard detail E2.3
• Cuts to the asphalt street will require a minimum final restoration of 20'full lane width grind and overlay. As well as additional
fees.
• 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 fromthe noise limits
of ECC Chapter 5.30 only during the hours of 7:00amto 6:00pm on weekdays and 10:00am and 6:00pni 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 ofhis or her spouse, heirs, assigns, and successors in interests, agrees to indemnify 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 fromthe issuance ofthis pennit. Issuance ofthis pen -nit 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.
• E-Traffic Control
• B-Final Restoration
• E-Engineering Final
PARTIAL INSPECTION DATE:
PARTIAL INSPECTION DATE:
FINAL INSPEC71ON APPROVED DATE:
INITIAL: NOTES:
INITIAL: NOTES:
INITIAL:
OV EVAj
IA11C.—I S") 0
RFCEIVED
JUN 17 2019 ROW PERMIT NO.: ENG
ENGINEERING DIVISION ISSUE DATE:
RIG[ I T-OF-WAY CONSTRUCTION RFCEIVED
PERMIT APPLICATION
BI-D
PROJECT NAME: /�160 1 �11
CONTRACTOR: I- QP-12jrnl%,�,r Ulej,)
Mailing Address: S4 Sc4i
State License #:
City Bushiess License #:
ADDRESS OR INTERSECTION OF CONSTRUCTION:
JUN 17 2019
CONTACT: ENGINEERING DIVISION
Mo,[-+\-/ 1-le n ,, �jrj '0 v-
pholle#: PJ6 081)
Fax #:
Email#: me
,�.- �/ @' () u wo., 4ef -, (—Ch^l
Li bility Insul'ance �onded
ROW WORK ASSOPATED WITH THE FOLLOWING TYPE OF PROJECT: - I
L-1 Commercial LLr Subdivision U City Project Ll Traffic Control (Only)
F1 Multi -Family El Single Family F] Other
F-I EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit? Ll Yes Ei"No
I ANY ASSOCIATED PERMITS? 11 BLD# -)61-7 13 33 ENG#
DESCRIPTION OF PROPOSED WORK (Be Speci fie) : Ujcjer/vlalK j'v%l-ljcXcL4l"
a V\ COA Oe-C- 1,-111 , S'I?A J er I h S �!!L 11,4 1 1656 L-, I I ftl 1-141 4 0 le-
cL pliox-,e, Ic lu be- t-ptf Wk2 ;?e- cuop-to-jecl olnAz
I r I I . 1
Z
WAS STREET OVERLAYED WITHIN THE LAST FIVE (5) YEARS? YES [�J�NOEI Year: 901$
PAVE MENT CUT: E(Yes n No If yes, indicate size of ellt: 4/- 1.? x 5,2,u
CONCRETE CUT: F1 Yes F] No Ifyes, indicate size of cut: x
wck 4u be- c0m,,-W i-, lAcu^l k 4 /&,1
0 qj e (O'y
RIGHT-OF-WAY
AREA
CLOSURE
TOTAL
DURATION
(NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF
Alley 72 Hrs + LF
Pai-Iiiiig 72 Hrs + LF
X
LF
SF
3 8U
X
LF
SF
X
LF1
SF
APPLICANT TO READ AND SIGN
*Traffic control and public safety sliall be in accordance witli City regUlations as required by the City
Etigincer. Every flagger must be trained as required by (WAC) 296-155-305 and must liave certification
verifying completion of the reqUired training in t1leir possession.
*Restoration is to be in accordance witli City codes and Standards. All street-CLIt trencli work sliall be
patelied witli asplialt 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 liave read the above statcnients and understand the permit reqUirenients and acknowledge that I must
follow all requirements in order for ffie permit to be valid.
SIGNATURE, C�� — IC-t CA i -IbAlk (I �jLe440— DATE
C'Contractoi, or Agent Y---
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
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