6.3.19 - ROW application.pdfROW PERMIT NO.: ENG
ISSUE DATE:
"'EIVEL,
RIGHT-O&WAY CONSTRUCTION ""o
1UN 03 2019
PERMIT APPLICATION
0L��c,-C)PMENT SERVICES
oj, TER
PROJE CT NAME: CONTACT:
LwA-�= SA,�& -- -
CONTRACTOR: Phone
—LV—A---e-1-tXe-A cc)w�
. 3-r -1w,
Mailing Address: Fax #:
G)� / V iv-1 L) U jjf�<- f It.
State LiceDSe #:
City Business License #:
Email#: t 1 4 e. f 4,�-f I -Z-
t'iability'Aniurance Bonded
ADDRESS OR IWERSEC'IJON OF CONs'rRUG1'1ON:
L J C'.
I ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
Commercial
F� Multi-Faniily
Subdivision
[:1 Single Family
D EUC(PUD, VERIZON, l"SE,
COMCAST, OVWSD):
Is this permit part of a blanket permit'?
City Project
n Other
F1 Yes El No
Traffic Control (Only)
I ANY ASSOCIATED PERMITS? I BLD# ENG# I
DESCRIPTION OF PROPOSED WORK (Be Specific): 11 j—'k.0
I WAS STREET OVERLAYE D WITHIN THE LAST FIVE (5) YE ARS? YES M NO 0 Year;
PAVEMENT CUT: P Yes E No If yes, indicate size of cut: ', (� x
CONCRETEcur: FX7, Yes E] No If yes, indicate size of cut: b (� x
RIGHT-OF-WAY
DURATION
AREA
TOTAL
CLOSURE
(NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF
X
LF
(T() SF
Alley 72 Hrs + LF
X
LF
SF
ParIdng72Hrs+ LF
X
16 LF
SF
APPLICANT TO READ AND SIGN
*Traffic control and public safety shall be in accordance with City VegUlaLions as required by the City
Engineer. Evet-y flagger rnust be trained as required by (WAC) 296-155-305 and must have coftification
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 asplialt or City approved material prior to [tie 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 ttie above staternents and understand the permit requirements and acknowledge that I must
follow allrequirernents in order for theperinit to be valid,
DATE '0
SIGNATURE
60r__'�Pkor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMITISSUANCE
SIGN SPACING = X (1)
R,IRAL ROADS & URSA% ARTER�ALS 35 140 MPH 35001
RURAL =ROADS& USRVB5AjNNESRT0E'RMlALjSC
RESIDE TS 25 f 30 MPH 200'1 (2)
URBAN STREETS 25 MPH OR LESS 107* M_
(1) ALL SPACING MAY BE ADJUSTED TO ACCOMMODATE
INTERSECTIONS AND DRVEVVAYS
(2) THIS SPACING MAY BE REDUCED IN URBAN AREAS TO FIT
ROADWAY COND'.nONS.
MINIMUM SHOULDER TAPER LENGTH = L/3 (feet)
SHOULDER
WIDTH
Posted Speed (mph)
_t)
(f�
25
X
35
1 40
45
50
55
60
1 65
1 70
8'
40
4.
�.
I .
-
-
-
10,
40
60
90
1 90
USE A 3 DEVICES TAPER FOR SHOULDERS LESS THEN V
BUFFER DATA
LONGITUDINAL BUFFER SPACE = B
SPEED (MPH)
25
30
35
40
45
50
55
60
1 65
70
LENGTH (feet)
155
200
250
305
360
425
495
570
1 645
730
TRANSPORTABLE ATTENUATOR ROLL AHEAD DISTANCE = R
HOST VEHICLE WEIGHT
9,900 TO 22,000 lbs
OST�VEHICLE WEIGHT
1 22,000 lbs
45 MPH
45-55 MPH
1
55 MPH
45 MPH 41-15 MPL�
100,
123'
1,:r
100,
�5MPH
1,
PROTECTIVE VEHICLE (WORK VEHICLE) = R
NO SPECIFIED DISTANCE REQUIRED
- - - - - - - - - - - - - -
WORX AREA
x U3 "R 50.
48' 41'
ROAD) 7
D
WORK OUR)
< WOL K
AHEAD)
Ic 48*
W21-5
CHANNEL17ATION DEVICE
SPACING (feet)
MPH TAPER TANGENT
35/40 30 60
:r 40
LEGEND NOTES
<1 TEMPORARY SIGN LOCATION SHOULDER CLOSURE -LOW SPEED 1 DEVICE SPACING FOR THE DOWNSTREAM TAPER SHALL BE 20'(FT)
13 CHANNELIZING DEVICES 2 ALL SIGNS ARE BLACK ON ORANGE.
PROTECTIVE VEHICLE (40 MPH OR LESS)
NOT TO SCALE
In NAME I.Wnn R P& S"ua"�%24Un 3hM IUbrA,yW'.-Plbh�d PSLIVC� Wo� X 7.9. C ITC-5) Sho�Wl CIft— L SpI-I (40 M14 or L—PTC-5 d9r,
TA ts 41 om PIM
DATE Irm"le ' ' FED AID PROJ NO 1111211"
"Lormo av W&v AS
DESIGNED 81 v7w T175
ENTERED NY
Washington State
M0J ENGR Department of Transportation
REGIONAL ADM. RWISION cArt By TRAFFIC CONTROL PLAN
2009 E.dition
Figure 61-1-28. Sidewalk Detour or Diversion
,A6
t
SIDEWALK DETOUR
Page 689
inches
N/11N.
D
OIL ROAD
W W
ORK
D
t------<-AHEAD
SIDEWALK DIVERSION
Typical Application 28
Note; See Tables 61-1-2 and 61-1-3 forthe meaning
of the symbols and/or letter codes used in
this figure,
December 2009 Sm 61101
Departmentof Labor and Industries
PO Box 44450
Olympia, WA 98504-4450
INTERWEST CONSTRUCTION INC
Reg: CC INTERC1121 OF
UBI:.601-029425
Registered as provided by Law as:
Construction Contractor
(CCO I) - GENERAL
128
INTERWEST CONSTRUCTION INC Effective Date: 9,/46/1988
609 NORTH HELL BLVD. Expiration Date: 11 /8/29019
BURLINGTON WA 98233
INTERWESTCONsTRUCTION, INC.
609 N HILL BLVD M A Y 2 8
BURLINGTON WA 90233-4000
BUSINESS LICINSE
STAIT. Of Issue Date: May '17, 2019
WASHINCION Unified Business ID 601029425
Profit Corporation Business ID 001
Location: 0003
INTERWEST CONSTRUCTION, INC. Expires: Jun 30, 2019
609 N HILL BLVD
BURLING-VON, WA 98233-4600
SCALE - LARGE (1) - ACTIVE UNEMPLOYMENT INSURANCE - ACTIVE
INDUSTRIAL INSURANCE -- ACTIVE MINOR WORK PERMIT - ACTIVE
TAX REGISTRATION - ACTIVE
CITY ENDORSEMENTS:
MOUNT VERNON GENERAL BUSINESS - NON-RESIDENT - ACTIVE
ANACORTES GENERAL BUSINESS - NON-RESIDENT- ACTIVE
BELLINGHAM GENERAL BUSINESS #027073 - ACTIVE
BLAINE GENERAL BUSINESS - NON-RESIDENT - ACTIVE
DUVALL GENERAL BUSINESS - NON-RESIDENT- ACTIVE
LAKE STEVENS GENERAL. BUSINESS - NON-RESIDENT (EXPIRES 7/31/2019) - ACTIVE
PORT TOWNSEND GENERAL BUSINESS - NON. -RESIDENT - ACTIVE
SEDRO WOOLLEY GENERAL BUSINESS - NON-RESIDENT #222295 - ACTIVE
SEQUIM GENERAL BUSINESS -- NON-RESIDENT - ACTIVE
BURLINGTON GENERAL BUSINESS #10030 (EXPIRES 12/31/2019) - ACTIVE
DUTIES OF MINORS;
Ages 16-17: Wash trucks / equipment, stock/ clean shop. 'MINOR MAY NOT WORK AT HEIGHTS GREATER THAN
10 FT OFF THE GROUND OR FLOOR LEVEL.'
LICENSING RESTRICTIONS:
11 Is the lusinegs's os,,,nslblllly to mrnpl, will rni n ... work perrni1,oqiernenls_9,e WAC 291-111-011ancl WAC
296-125-033 for Non-AgricultUral and WAC 296-131-125 for Agricultural guidelines and restricted artivities.
Occupallons Involving operatIon, repair, cleaning, adjusting or setting up of any power -driven wood -working machines
is prohibited for minors under the age of 18. WAC 296-125-030(5)
Ibis doctimeni libl, the rqkirilioos, aui Ii. vo��, wiko,;v,d fo, 0,� , �i
liamcdabow. fly mxqoing (his dot ammi, mimom000 m z4e���
w,i� compildr, lrtw,andimorale to III(, be;f of his or her knowlfniyp�l cold that joAsio"� will kv
canducted ir":("111)liance With all applicable washingion staie, cau"O.,;md dl� Di"!, lo, thol'a'Im"nI ") Rr,
UBI: 601029425 001 0003
INTERwEs-r CONSTRUCTION, INC.
609 N HILL BLVD
BURLINGTON, WA 98233-4600
9.0002
FiyxrF. riF wjvmw.�,rcm
SCALE - LARGE (1) - ACTIVE
UNEMPLOYMENT INSURANCE -
ACTIVE
INDUSTRIAL INSURANCE - ACTIVE
MINOR WORK PERMIT - ACTIVE
TAX REGISTRATION - ACTIVE
MOUNTVERNON GENERAL
BUSINESS - NON-RESIDENT,
ACTIVE
ANACORTES GENERAL BUSINESS
NON-REL.ADENT - ACTIVE
BELLINGHAM GENERAL BUSINESS
#027073 - ACTIVE
BLAINE GENERAL BUSINESS -
NON-RES1 DENT - AC-1 IVE
DUVALL. GENERAL BUSINESS -
NON-RESIDENT - ACTIVE
.. ,j " 0- ,
Expires: Jun 30, 2019
to!. .... . ......