ENG20140506.PDFs - -
Vey OF C� O cn
_ ° CITY OF EDMONDS
121 5TH A VENUE NORTH - EDMONDS, WA 98020
PHONE. (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20140506
Permit Number: ENG20140506 Expiration Date: 04/07/2015
Job Address: 16031 75TH PL W, EDMONDS Location:
INFRASOURCE CONSr-PSE INFRASOURCE CONST-PSE
13330 STONE AVE N 13330 STONE AVE N
SEATTLE, WA 98133 SEATTLE, WA 98133
(206)949-5846
LICENSE N: INFRACL899CZ EXP: 02/14/2015
One at a time occupying the N and S bound lanes of 75th Pl. W to install gas service to 16031- 75th PI. W. 2 (3x5) gravel cuts
anticipated.
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
INDEMA7TY.- The Applicant has signed an application which 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 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.
THECONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCEOFTHEWORK.
• 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 DLAI A -DIG (1-800424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECITON (425) 771-0220 EXT. 1326
24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQUESTS
THIS APPLICATION IS NOT PERMIT UNTIL SIGNED BY THE CITY ENGINEEROR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN
SPACE PROVIDED.
Printed: Tuesday. October 07.2014
RELEASED BY
)H7LECOPY INSPECTOR APPLICANT COPY
11
STATUS: ISSUED
ENG20140506
• 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.
• Verify clear bore crossings
• Utility patch restoration to 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 pemvtted project.
• Sound/Noise originating fromtemporary construction sites as a result ofconstruction activity are exempt fromthe noise limits
of ECC Chapter 5.30 only during the hours of 7:00am to 6:00pm on weekdays and 10:00am and 6:00pm 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 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 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.
• E-Traffic Control
• E-Fngineering Final
PARTIAL INSPECTION DATE: INITIAL: NOTES:
PA RTIA L INSPECTION DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: INITIAL:
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ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME:, I C(E $ Tq
CONTRACTOR:
Mailing Address: 133?iCr S,ynnn five. A)
State License #: //,FPASL$7-1 G2
City Business License #: AJP, _ Q1q !R4 0
CONTACT:
JU-lle— Sirv,rn.or,s
Phone #: .,
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Fax #:
Email #:
Jtn le . &mrr►tnS 2 Se-, Ca
Liability Insurance 0 Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: ) 6G �) I 61 1 el 10
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT: �
❑ Commercial ❑ Subdivision ❑ City Project ❑ Traffic Control (Only)
❑ Multi -Family ❑ Single Family
19f EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit?
❑ Other
❑ Yes ❑ No
ANY ASSOCIATED PERMITS? BLD# ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) : (2)(o- ql- 0. i'n..e OCC-941"
+kz ts) Ovid IN lnCsmd lA2o: ,-AP 75"� (2/ (A/ +6 in,-S- l( arec .yprmco in
1 % 03 ` 25r- 01 Ind - 2_ (3� Siata�' C LA-S
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES El NO ❑ Year:
PAVEMENT CUT: ❑ Yes Kf No If yes, indicate size of cut: x
CONCRETE CUT: ❑ Yes M No If yes, indicate size of cut: x,
RIGHT-OF-WAY AREA TOTAL DURATION
CLOSURE(NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF X JLF SF
Alley 72 Hrs + LF X LF SF
Parking 72 Hrs + LF X LF 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 he/she hold the City of
Edmonds harmless from injuries, damages or claims of any kind on description
whatsoever, foreseen or unforeseen, that may he 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 2/30 V
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
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A UANTA SERVICES COVPANY
Job#106287982
16031 75th PI W, Edmonds, WA
September 30, 2014
Sheet 1 of 2 eduard.volianskyi@pse.com
(206) 418-4218
Notes:
1. All signs and spacing to conform to the MUTCD
and City of Edmonds standards.
2. All sidewalks, driveways, exits and egresses shall be
completely clear unless otherwise indicated.
3. Channelizing devices are 28" traffic cones.
4. Sign size can be a minimum of 48" x 48" and shall not
obstruct pedestrian access.
5. Crew is required to leave a minimum of 11' for traveling
lane width.
6. Alert affected residents and businesses.
7. Work to take place between 9 a.m. and 4 p.m.
8. Work area will be 300' SCL of N Meadowdale Rd
& 12' WCL of 75th PI W.
9. If used, place NO -PARK signs 72 hours in advance
r the aav inat ine worK Is to De none.
Applicant shall repair/replace all damage to
Utilities or frontage improvements in City
right -of --way per City standards that is caused
Of occurs during the penrrRted project.
APPROVED AS NOTED
BY GINEERING
Date: IOL71iq
3_ t-A
162nd SR SW
0ANERiC31gT A,;:"iOR IS R23POI fSKE FOR
EROSION CONTROL AND DRAINAGE
LEGEND
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28" TRAFFIC CONE'
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BORE PIT
TRAFFIC FLOW
TtFLAGGER
WORK VEHICLE
SIGN LOCATION.
WARNING FLAG
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A C)UANTA SERVICES COMPANY
Job#106287982
N MEADOWDALE RD
16031 75th PI W, Edmonds, WA
/
September 30, 2014
Sheet 2 of 2 eduard.volianskyi@pse.com
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(206) 418-4218
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162nd SR SW
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Notes:
1. All signs and spacing to conform to the MUTCD
and City of Edmonds standards.
2. All sidewalks, driveways, exits and egresses shall be
completely clear unless otherwise indicated.
3. Channelizing devices are 28" traffic cones.
4. Sign size can be a minimum of 48" x 48" and shall not
obstruct pedestrian access.
5. Crew is required to leave a minimum of 11' for traveling
lane width.
6. Alert affected residents and businesses.
7. Work to take place between 9 a.m. and 4 p.m.
8. Work area will be 300' SCL of N Meadowdale Rd
& 12' ECL of 75th PI W.
9. If used, place NO -PARK signs 72 hours in advance
of the day that the work is to be done.
LEGEND
®
28" TRAFFIC CONE
®
BORE PIT
TRAFFIC FLOW,
FLAGGER
WORK VEHICLE
SIGN LOCATION
WARNING FLAG
.ev. J Pine 7, -i)J.s
Job #:
Date:
Jurisdiction;
Est. Start Date:
Est. Duration:
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PRE -INSPECTION FORM
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Address: I b O 3 l % 5 f'
City / Zip: '- r ` ? A-;4+_�
Customer:
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Flaggers M# 'Z.- Police. Flaggers 'trolley Lines (❑ Bus Stop ❑ #Meter Hoods ❑ #
Speed Limit ❑ # Traffic Sign 1❑ Arterial. ❑ No Parks ❑ #
Commercial Altered Commercial ❑ teak Repair ❑ Service Information Bollards ❑2.5"04"#_
Residential Altered Residential ❑ CP Work ❑ Diameter Meter 5FV Template Bar. ❑
Multi -Family❑ Replacement Service[] Pothole ❑ 5/8 ❑ 250 -19 1800 ❑ Fuel Line Permit ❑
New Service aMain Maintenance ❑ Extension ❑ 1 1/8"{@ 425 ❑ 2600 (fir Fuel Line Length
Stub ❑ Service Maintenance[] Complete 1 1/4" ❑ 630 ❑ 10,000❑ Fuel Line.Diam.
Cut & Can ❑ Valve Maintenance ❑ Service R 2" ❑ 1000❑ Meter Location tt? iS
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