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ENG20160478.pdft' E I7 uITY OF, EDMONDS 121 5THAVENUENORTH-EDMONDS, WA 98020 7u 11nI PHONE: (425) 771-0220 - FAX: (425) 771-0221 *PERMIT MUST BE POSTED ON JOBSITE* STATUS: ISSUED ENG20160478 Permit Number: ENG20160478 Expiration Date: 08/01/2017 Job Address: 1133 SIERRA PL, EDMONDS Location: 1133 Sierra PI APPLICANT PSF/Infras ource CONTRACTOR P SE/In frasource C/O Susan att: Sidick C/O Susan art: Sidick 1660 Park Lane 1660 Park Lane Burlington, WA 98233 Burlington, WA 98233 (425)457-6353 LICENSE #: infrasl871 c2 EXP: 02/22/2017 Short side 1-1/8 service. 425 meter. This service has a streamthat we will need to cross. A streamand concrete culvert are T deep I wouldlike to go over the top with the rest of the utilities (power, phone, cable, water). Construction management and I both agree that we need to stay in the driveway making as few cuts as possible. We will be able to maintain separation between other utilities including the culvert if we go'2'to 3' deep and straight down the driveway. DISRUPTION INFORMATION ASSESSED' VALUE: $0,00 PROPERTY AREA: 0 SIDEWALK: (OXO) DURATION IN MONTHS: 0 FEE, $0,.00, STREET DISRUPTION TRENCH CUT: ( 3,X 5 PARKING: ( OX0) DURATION IN MONTHS: 0 FEE° $0,00" YEAR OF OVERLAY: 0 FEE: $0,00 ALLEY 0X0 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 maybe 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 atlorney fees by reason ofgranting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONEYEAR 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. CALLDIALrA-DIG (1-800-424-5555) BEFORE ANY EXCAVATION CALL FOR INSPECTION (425) 771-0220 EXT. 1326 24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQUESTS THIS APPLICATION IS NOTAYERMITUNTIL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPTISACKNOWLEDUED IN SPACE PROVIDED„ Printed: Wednestig, Febnwr 01' 2017 RELEASED BY DATE ❑ FILE COPY F-1 INSPECTOR COPY F APPLICANT COPY ENG20160478 • 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. • Applicantshall 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 7:00amto 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays, excluding Sundays and Federal Holidays. At all other tines 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. INSPFCTIONS • E -Engineering Final PARTIAL INSPECTION DATE: INITIAL: NOTES: PARTIAL INSPECTION DATE: INITIAL: NOTES: FINAL INSPECTION APPROVED DATE: INITIAL: a.7. it ` [t-'A'le-1. ROW PERMIT NO.: ENG ,,? (°s_ ,. . ISSUE DATE: PROJECT NAME: 106318081 CONTRACTOR: PSE/Infrasource 1660 Park Lane, Burlin Mallln J Address: glon, WA 98233 State License #: INFRASL871 C2 ------- City Business License #: NR -019840 CONTACT: Sue Sidick Pllolle #: 425-457-6353 ..... ...... Fax #: NOV 2 fit 2"0 46 P 4 "- I �"oit i:��4,l,H.li ^14'd � Im�Md,�d11 <a^� nfiV'I I mail #: Susan.Sidick@pse.com ❑ Liability Insurance Bonded ADDRESS OR INTERSECTION OF CONS`1'RUCTION: 1 133 Sierra PI ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT: Commercial Subdivision�City Project I_► affic Co"liLL trol (Only)-"... ❑ Multi -Family ® Single Family D Other ❑ .EUC (PUD, VERIZON, PSE, COMCAS`I', OVWSD): Is this permit part of blanket permit? ❑ Yes ® No ANY AS50C IA1 F,1� PERMITS �i n# rNc# _.. DESCRIPTION OF PROPOSED WORK (Be Specific) :1-110 ` orvveo 425 meter this service hasaslream that wa will need to cross whorl -Side ..�..�,�,�,�,.._.�,.,.�,.,�,..,,,.__.,,,,.................,,,,...,_............,,.,............._........_...._.....w�...,m a stream and concrete culvert are 7' deep. I would like to go over the top with the rest of the utilities (power,phone, cab le,water.) Construction Management and I both agree that we need to stay in the driveway making as few cuts as possible.. We will be able to maintain separation between the other utilities including the culvert if we go 2' to 3' deep and straight down the driveway. SET Ovr>ai�A��r.... vI' (5)YEARS? .L NO Veal m 1066 .`.S STI3 D �'�IITIITN THIS LAST FI PAVEMENT CUT: M Yes, E No If yes, indicate size of ctlt: _..x 5 CONCRETE CUT: F1 Yes F-1NoIf yes, indicate size of cut: r APPLICANT TO READ AND SIGN or�x�r�rc°u..u�w.a�.�r. r...e:.—.—..wa...a.u.�u ,.�.u:rs�aurm ,.wwxae�ar�m ,��.�rvuo:�^�umnr urerxrvrrrm�,��aro�uumrm warm, ., i mwiwmr.uru�.awecww.uww�iwaru�r�a.;.r�.rmuwmrrr.�.uuwn �u..wwwawuwuu ..�mu�uww,wwmuwaw *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 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. Susan Sidick 11 /22/2016 SIGNATURE � � �M��wM �,�" °° "s �°" DATE Contractor or Agent NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE PERMIT REQUEST FORM Date of Request: 11/21116 Job number: 106318081 Job address: 1133 Sierra PI City: EDMONDS Zip: 98020 Project mgr: Andrew Baunsgard _ PM contact #: (425) 495-4465 PM email: andrew.baunsgard@pse.com Estimated job start date: 12/19/16 Estimated job completion date: 01/27/16 Description of work to be performed: 4hnrt-Sidor 1-1/2 sarvira 49..q mortar This SP „ira hnz n c r aM haf x Will fn r-mcc n stream and concrete culvert are 7' deep. I would like to go over the top with the rest of the utilities(power,phone, cable,water.) Construction Management and I both agree that we need "t 1ny1 -tI -., i mnc y-niuklug- ,Tf l I_ t l to Innintain e1�r�tac�-t�etwee�°�-tf that-ut+tiItes�ita�dltat�-�+s..�tv-art-tf-via-..-�.�t-"_d�atr-Nit--- Pavement cut? V Yes No If yes, Dimensions of Cut: Length 5 Width 2 How many cuts? 1 Surface Type Asphalt Require trenching? MYes. ©No If yes, Dimensions of trench: Length 5 Width 2 _ Depth 36 Method of installation: Hole hog Traffic impact: Road closed Yes Ev/] No Lane closed 171Yes D No How Many? I Direction? East Shoulder closed es No Sidewalk closed El Yes �No Emergency Contact: Andrew ns Bau gard Cell Number.' (425) 495-4465 w U 0- } J O 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 [raveling lane width. 6. Alert affected residents and husinesses. 7. Work to lake place between'7a.m. and M. VZ 8. Work area will be 18' NCL of SIERRA PL & 400' ECL of THE CIL OF OLYMPIC AVE. 9. If used, place NO -PARK signs 72 hours in advance of the day that the work is to be done. -7 1133 SIERRA PL PUGET P .SOUND ENERGY Job$106318081 1133 SIERRA PL EDMONDS, WA NOVEMBER 18, 2016 Sheet 1 of 1 sally.bergman@pse com (425)398-6003 �"4�"'a11t�ur r CMAB AN ............. _._. LEGEND ® 28' TRAFFIC CONE IZAI"ION BORE PIT DEVICE SPACING TRAFFIC FLOW MVI TAnF17� reJ7Gk 46 Q kt+J WORKVEHICLE � 35145 70 -� rI� J"dJ Lo-� +i0 SIGN LOCATION A. al•2 WARNING FLAG PUGET P .SOUND ENERGY Job$106318081 1133 SIERRA PL EDMONDS, WA NOVEMBER 18, 2016 Sheet 1 of 1 sally.bergman@pse com (425)398-6003 �"4�"'a11t�ur r CMAB AN Job #: 106318081 Date: 11/15/16 Jurisdiction: Edmonds Right of Way Permit? M YES E] NO Est. Start Date: Est. Duration: 04NANQUIUMA PRE-INSPECTION PRE -INSPECTION REPORT * - I �0UNbMuRIGY Address: 1133 Sierra PL City / Zip: Edmonds Customer: Derek 310-245-5848 ,[jq NU��RF T PHONE PM / Insp: A. Sauna and PHONE NUMBER Open Trench ❑ 5hort-side 100'1-118 set -vice, 425 njetei^ rvice will cross a 9ridge. Trenchless PLAT MAP: 4) > 1611 concrete culvert 7' deep from grade CL E. ... ....... O 0VhJ7N­dV 14piojj�mq%v% e)(�� 2" STW IP 18'N CL 4022-1962 Sierra PL a A—' A,iJ7Aok) 4 1f%k#Jir40M 01"'S CtO 1 ILA L 6,t Size of Cut I Surface Type [-] METER HOODS # Ej NO PARKS # F EFV ❑ Bollards 2.5" # ❑ 1800 2600 ❑ Bollards 4" # L Work Location 6 of CL_ Qlylmp[c_A� of CL Fuel Line Diameter: 'E W of CL 'N S of CIL 'E W of P1 FLAGGERS * 1 25 MPH ❑ TROLLY LINES E] BUS STOP [-I OFFICERS i- SPEED LIMIT ❑ TRAFFIC SIGNAL [_1 ARTERIAL Ej Commercial [:] Altered Commercial ❑ Leak Repair service Iniormtloi Ej Residential E] Altered Residential ❑ CP Work Diameter Meter Multi -Family E] Replacement Service ❑ Pothole ❑ 5/8" ❑ 250 New Constr. E] Main Maintenance ❑ Extension 1118" Q 425 Ej Stub ❑ service maintenance ❑ 11/4" E] 630 ❑ Extension ❑ Valve Maintenance L] 211 ❑ 1000 Compete Sery ❑ Cut & Cap Mtr Loc: -- Size of Cut I Surface Type [-] METER HOODS # Ej NO PARKS # ❑ Template Bar EFV ❑ Bollards 2.5" # ❑ 1800 2600 ❑ Bollards 4" # E] 10,000 E] FUEL LINE PERMIT NEEDED Fuel Line Length: Fuel Line Diameter: