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"A CITYOFEDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
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Number:Permit 1 1' i • 1. 1 1 14
Job Address: 23320 HIGHWAY 99, EDMONDS Location:
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SNOHOMISH COUNTY• • •
2 10 18 HIGHWAY 99 21018 HIGHWAY 99
EDMONDS, WA 98026 EDMONDS, WA 98026
(425) 670-3216
LICENSE #: EXP:
SET (1) 55' DISTRIBUTION POLE FOR NEW PRIMARY UNDERGROUND SERVICE FOR COMMERCIAL BUILDING. OLD
POLE WILL BE REMOVED. THIS IS A POLE RELOCATION PROJECT. WILL BE FRAMING THE NEW POLE FOR THE
PRIMARY UNDERGROUND FOR THE COMMUNITY HEALTH CENTER. WO#3 8 8927-03.
ASSESSED VALUE: $0.00 PROPERTY AREA: 0
SIDEWALK: (OXO) DURATION IN MONTHS: 0 FEE: $0.00 STREET DISRUPTION TRENCH CUT: (OXO)
PARKING: (OXO) DURATION IN MONTHS: 0 FEE: $0.00 YEAR OF OVERLAY: 0 FEE: $0.00
AH `Y: (0X()) DURATION IN MONTHS: 0 FIT $0,00
INDEMNITY: The Applicant has signed an application ivhich states he/she holds 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 but not limited to the defense of any legal proceedings including defense costs and
attorney fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK.
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 DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT. 1326
24 HOUR NOTICE REOI dI Rh;D FOR ALL INSPECTION
UNTIL SIGNED 13V THE CITY ENGINEER OR HIS/HEI
SPACE PROVIDED.
FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN
Printed;
❑ FILE COPY ❑ INSPECTOR COPY [] APPLICANT COPY
N 2, 2013
. 'vV PERMIT NO.:
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RIGHT-OF-WAY cONTSrituCTION
PEI RMIT UA TION
PROJECT NAME. COACT:
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Mailing, Address - � � Fax ff:
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Business .
iabilit3rfas rance , Bonded
License
❑ ,Multi -Family ❑ Single Family ❑ Other
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Here is the permit request for the project at 23320 highway 99.
I believe you have been in contact with Rick Martin on this project.
Per our conversation, you were agreeable to let us use Ricks ROW Traffic Plan that he had
previously submitted.
So I have included that with the permit application.
I understand that the Forman is waiting to have the pole relocated as soon as possible.
Any help you can give us in expediting the permit will be much appreciated.
Thank you,
Mary McAllister
Senior Designer
Distribution Engineering Services
[425] 670-3216
[425] 670-3210 Fax
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