ENG20160053.PDF1*1
OF E MD�N
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
irye 1 g90 PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20160053
RIGHT OF WAY PERMIT (6-EUC)
Permit Number: ENG20160053 Expiration Date: 08/29/2016
Job Address: 19316 OLYMPIC VIEW DR, EDMONDS Location: 19316 Olympic View Dr
PSF/Infrasource
PSE/Infrasource
C/O Susan att: Sidick
C/O Susan att: Sidick
1660 Park Lane
1660 Park Lane
Burlington, WA 98233
Burlington, WA 98233
(425)457-6353
LICENSE 4: infras1871 c2 EXP: 02/22/2017
Permission is requested to install 1 1/8 gas service to 19316 Olympic View Dr at approx work area will be 5-14' E c/I of Olympic View Dr
and 2Y w c/I of Olympic view dr & 110' N c/I of Olympic Avenue. 1 2x5 paving cut anticipated.
INFORMATIONDISRUPTION
ASSESSED VALUE: $0.00 PROPERTY AREA: 0
SIDEWALK: (OXO) DURATION IN MONTHS: 0 FEE: $0.00 STREET DISRUPTION TRENCH CUT: ( 2 X 5 )
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 ofiis 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 RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OFONEYEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OFTHEWORK.
• 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 (1-800424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT.1326
24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQUESTS
THIS APPLICATION IS NOTA PERMITUNTIL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN
SPACE PROVIDED.
Printed: Monday, February 29, 20
BY
O�PUCOPY ❑ INSPECTOR COPY ❑ APPUCANT COPY
STATUS: ISSUED ENG20160053
• 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 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 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 6:00pm 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.
�- • &Traffic Control
• &Engineering Final
PARTIAL INSPECTION
PARTIAL INSPECTION
FINAL INSPECTION APPROVED
DATE:
DATE:
DATE:
INSPECTIONS
INITIAL:
INITIAL:
INITIAL:
NOTES:
NOTES:
.of E`'"''��• RCO E®
v
N FEB 1 �.. 2016
ROW PERMIT NO.,: ENOO —005S
DEVELOPMENT SERVICES ISSUE DATE:
RIGHT-OF-WAY CONST'RUCT'IO
FEB 16 20
PERMIT' APPLICATION16
ENGlNEEAINC DIVISIO�y
PROJECT NAME: 106307313 CONTACT: Sue Sidick
CONTRACTOR: PSE1lnfrasource Phone #: 425-457-6353
Mailing Address: 1660 Park Lane, Burlington, WA 98233 Fax #'
State License #: INFRASL871 C2 Email #' Susan.Sidick@pse.com
City Business License #: NR7019840 Liability Insurance [I Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 19316 Olympic View Dr
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
❑ Commercial ❑ Subdivision ❑ City Project Lj Traffic Control (Only)
❑ Multi -Family ❑X Single Family
❑ EUC (PUD, VERIZON, PSE,
COM.CAST, OVWSD):
Is this permit part of a blanket permit?
❑ Other
❑ Yes . ® No
ANY ASSOCIATED PERMITS? BLD# ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) : Permission is requested to install 1 1/8 gas
service to 19316 Olympic View Dr at approxworfk area will be 5-14' E c/i of Olympic View dr and 20' w c/i of Olympic View Dr & 1 10'n ch
of Olympic Ave. 1 2x5 paving cut anticipated.
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES ❑ NO Year:10621
PAVEMENT CUT: M' Yes ❑ No
CONCRETE CUT: [—]'Yes 0 No
Ifyes, indicate size of cut: 2 x 5
If yes, indicate size of cut: x
RIGHT-OF-WAY
AREA TOTAL
CLOSURE
DURATION
(NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF
X
X
LF SF
LF SF
Alley 72 Hrs + LF
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 he 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 the permit to be valid.
SIGNATUREJ1DATE 02/12/16
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
LEGEND.
®
. 28' TRAFFIC CONE
®
BORE PIT
TRAFFIC FLOW
•FLAGGER
WORK VEHICLE
SIGN LOCATION..
p�p
l .t
WARNING. FLAG .
V.i'-K
D
0
n`�I
XI
/ Boa 'yG
1P
R
CHANNELIZATION
DEVICE SPACING
MPH
I TAPER
I TANGENT
55/70
I40.
80
35/45
1 30
60
25/30
1 20
40
PUGET
' SOUND
ENERGY
Job#106307313
19316 Olympic View Dr, Edmonds, WA
Feb 10, 2016
o; Sheet 1 of 2 patrick.mcghuey@pse.com
Q (360)570-6801
W
Applicant sphaM repair/ropl ci all t�84fime to
J Utilitie2 or ff V ritage U tiprOVar`JRent'l Eti cRy
° right-of-way per City �tendarO N-kst to wmaad
or occurs daring the p Iftad prcjicc.
OWNER/CONTRA" . OR IS RESPONSIBLE FOR
EROSIO14 CONTROL AND DRAINAGE
ENOIN ERINQ DIVOON
APP VED AS NOTED
Date: _a/".
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 5' and 14' ECL of Olympic View Dr &
approximately 110' NCL of Olympic Ave.
9. If used, place NO -PARK signs 72 hours in advance
of the day that the work is to be done.
0
W3-H
a
LEGEND
® . 28*3RAFFIC c0NE
® BORE PIT
.TRAFFIC FLOW
FLAGGER
WORK VEHICLE
SIGN LOCATION
p�p WARNING FLAG
:CHANNELIZATION
DEVICE SPACING
MPH
TAPER
TANGENT
55/70
40
80
35/45
30
60
25/30
20
40
�_ Gu•Z
3_ q
PUGET
' SOUND
ENERGY
Job#106307313
19316 Olympic View Dr, Edmonds, WA
Feb 10, 2016
Sheet 2 of 2 patrick.mcghuey@pse.com
(360) 570-6801
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 20' WCL of Olympic View Dr &
approximately 110' NCL of Olympic Ave.
9. If used, place NO -PARK signs 72 hours in advance
of the day that the work is to be done.
- - --
.
Date of Request:
Job number:
Job address:
Project mgr:
PM email:
PERMIT REQUEST FORM
02/11 /16
106307313
19316 Olympic View Dr City: Edmonds Zip: 98020
Teresa Bradford
teresa.bradford@pse.com
Estimated job start date:
Estimated job completion date:
04/18/16
04/22/16
PM contact #: (425) 457-9386
i<
is
Description of work to be performed:
Window over water in asphalt. Alternating lane closures.
Pavement cut? M✓ Yes E]No
If yes, Dimensions of Cut: Length 2' Widtk 5'
How many cuts? 1
Surface Type asphalt
Require trenching? ®Yes E]No
If yes, Dimensions of trench: Length Width Depth
Method of installation
hogging
Traffic impact:
Road closed ElYes
F No
Lane closed
[Dyes
E]No
Shoulder closed J-:-A
No
Sidewalk closed
®Yes
No
Emergency Contact: Mike Blood
Cell Number: (425) 864-6154
How Many? 1
Direction? South
g161067 fhltp://sesoamsl/map_lile/gis/mapviewer/plal/g161067.ti Page 1 of 1