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ENG20160512.pdfA t1� Su�hld7 CITY'OF EDMONDS 121 5THAVENUENORTH-EDMONDS, WA 98020' PHONE: (425) 771-0220 - FAX: (425) 771-0221 *PE S ,M ST BE POSTED ON JOBS TE* Job Address: 8223 208TH ST SW, EDMONDS Location: 8223 208th St SW 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 #: infrasl87lc2 EXP: 02/22/2017 JOB DENCRIPTION Work area is approx 14' S c/1 of208th St SW'& 5' E c/1 of 83rd Ave W . to install gas service. "13X5 paving cut anticipated. DISRUPTION INFORMA,rioN ASSES,SF,D VALUE $0,00 PROPERTY AREA: 0 SIDEWALK: (OXO) DURATION IN MONTHS: 0 FEE: $0„00 STREET DISRUPTION TRENCH CUT: ( 3 X 5 ) ,PARKING: ( OXO') DURATION IN MONTHS: 0 FEE: $0,00 YEAR OF OVERLAY: 0 FEE: $0,00 AL�LF'Y. ” ( 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 at- claims,ofanykind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds or any ofils departments or employees, including but not limited to the defense ofany legal proceedings including defense costs and attorney fees by reason ofgranting lhispermit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR <A PERIOD OFONEYEAR FOLLOWING THE FINAL INSPECTION AND; ACCEPTANCE OFTHEWORK r 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 NOTICEREQUIRED FOR ALL INSPECTION REQUESTS THIS APPLICATION IS NOTA PERMITUNTIL SIGNED BY THE CITY ENGINEER OR'HIS/HER 'DEPUTY: AND FEES SPACE PROVIDED. C12nkit a Wa ykiiol 11612,017 RELEASED BY FILE COPY F-1 INSPECTOR COPY El APPLICANT COPY STATUS: ISS ENG20160512 • 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. • Maintain 10's eparation from the water main 90 degree bend and proposed line. • 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 pemnitted 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 of7:00amto 6:00pmonweekdays and 10:00amand 6:00prn 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 -Engineering Final PARTIAL INSPECTION DATE: INITIAL: NOTES: PARTIAL INSPECTION DATE. INITIAL: NOTES: FINAL INSPECTION APPROVED DATE: INITIAL: els ��• Lt•�Y'L.'�� $1, NN . u N, :5 .�,.,�Jr'lk)l1,73,1.j r '1! Wk�di ROW PERMIT NO.: ENt J ` 6V 2% ISSUEDATE: FW'1'11VF 16 PROJECT NAME: 106318403.. �.�: �.� CONTACT- _�� Sm-,,, Sidjt 4�'...... .... CONTRACTOR: PSE/Infrasource Pholle #: 425-457-6353 Mailing Addi-ess: 1660 Park Lane, Burlington, WA 98233 State License #: INFRASL871 C2 �...�...��.m............. ..--- _ CityItit BusinessNP-019840 Business LId.E115E #: Fax #: I?mail #: Susan.Sidick@pse,com ...... ..m.-__ ❑ Liability .Insul a„ce U Bonded ADDRESS OR INTERSECTION OF CONSTRUCTION: 8223 208th ST SW ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT: � S , � � - City Project . 1..P� C - �� I I Traffic Control (Only) �o,nn1E,•ciaI Subdivisull� ❑ Multi -Family 0 SiugleFanlily Other. ❑ L` lJC (PUD, Y1' RIZON, PSE, C.OMCAST, OVWSD): Is this permit part ol-a blanket pei-mit? ❑ Yes ®No ...... ....... ANY ASSOCIATED PORP C 1, F--� ENG - 411- l DESCRIPTION OF PROPOSED WORK (Be Specific) : Work area is approx 14's c/I of 208th ST SW & 5' E C/I of 83rd AVE W . To install gas service 1 3x5 paving cut anticipated WAS SIRE I' OVI+RLAYED WI HIN THE LAST I+IVI+ (5) YEARS? YES {�� NO F-1 Yea,._ 106 PAVEMENT CUT: ® Yes ❑ No If yes, indicate size of cut: 3 x 51 CONCRETE CUT: L] Yes ❑ No If yes, indicate size of cut: m x APPLICAN'TTO READ AM) SIGN *"traffic control and public safely shall be in accordance with City regulations as required by the City Engineer. Every flagger nitist be trained as required by (WAC) 296-155-305 and 111L1,St have certification verifying et- nk, � completion ofthe 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 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 departinents or employees, including defense costs and attorney fees by reas of I grnting this permit. a I have read the above statements and L)nder°stand the peni-ilt recInn-einen(s and acknowledge that I ITILJqt follow all reqtiiren)ents in order for the permit to be valid. SLASal-I Sidick DATE 12/22/2016 SIGNATURE ...... . . . . ........ Contractor or Agent NO WORK SHALL BEGIN PRIORTO PERM ITISSUANCE RlGlJ -OF-WAIT DURATION AREA ro'lrAL CLOSIAW (NUNW.ER OF MONTHS) Sidewalk 48 Hrs + m" x LF SF . . . . . . . . . . ....... . . .......................... - -------- Alley 72 fIrs + LF x LF SF Parking 72 Hi -s + LF X LF SF APPLICAN'TTO READ AM) SIGN *"traffic control and public safely shall be in accordance with City regulations as required by the City Engineer. Every flagger nitist be trained as required by (WAC) 296-155-305 and 111L1,St have certification verifying et- nk, � completion ofthe 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 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 departinents or employees, including defense costs and attorney fees by reas of I grnting this permit. a I have read the above statements and L)nder°stand the peni-ilt recInn-einen(s and acknowledge that I ITILJqt follow all reqtiiren)ents in order for the permit to be valid. SLASal-I Sidick DATE 12/22/2016 SIGNATURE ...... . . . . ........ Contractor or Agent NO WORK SHALL BEGIN PRIORTO PERM ITISSUANCE Notes: 1. All signs and spacing to conform to the MUTCD t. „.,,.. 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 minimunl of 11' for traveling lane wtdlh- 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' ECL of 83rd Ave W & 14' SCL of 2081h St SW, 9. If used, place NO -PARK signs 72 hours in advance of the day that the work is to be done, #8223 I 208th St SW CHANIJELIZATION DEVICE shAcwc IF H "TAPER TAN6E00 N 1' r+:u i add ,506 �0.,.. m 30 bu :w L5f30 20 40 J1nn1 r I P UGET SOUND ENERGY Job#106316403 8233 2061h SL SW Edmonds, WA December 21st, 2016 Sheet 1 of 2 mitchell pelerson@pse,com 425-396-6071 ti a� M LEGEND 2F TRAFFIC CONE RQRf PIT TRAFFIC FLM FIAGGEft wOR10101ICLE j SIGN LOCATION s.wnnrlNC11 F`AG pTlj I A�o."' Notes: 1. All signs and spacing to conform to the MUTCD CL IIw�� and City of Edmonds standards. 28' TRAFFIC CONE 2. All sidewalks, driveways, exits and egresses shall be completely clear unless otherwise indicated. m 3. Channelizing devices are 28" traffic cones. rHAFHC FLOW j 4, Sign size can be a minimum of 48" x 48" and shall hot obstruct pedestrian access. 5. Crow is required to leave a minimum of 11' for traveling FLAGGIR lane width. 6affected rbusinesses 7. Wok to lake place between 9 a,mandp SIGN LOCATION 8. Work area will be 5 ECL of 83rd Ave W & 1 4' NCL of 208th 5t SW. 9. If used, place NO -PARI( signs 72 hours in advance N of the day that the work is to be done. wry w rI S'- RESIDENT(S) WILL BE INFORMED #8223 OF POSSIBLE TEMPORARY DRIVEWAY CLOSURE 2081h St SIN y4 > e Q Cb �i Vol Vol "q " Ip ey` � 1 ' �+ k CRANNELIZATION DEVICE SPACINC MPH TAPER A1, ;l N_i l4 I "5I o 40 tlfG ..3 �I45 It g 3D h'tCY .e � PUGET .SOUND ENERGY ,1ob44106318403 8233 208th St SW Edmonds, WA, December 21 sl, 2016 Sheet 2 of 2 mitchell.pelersonnpse.com 425-398-6071 LEGEND CL 28' TRAFFIC CONE D BORE PIT m rHAFHC FLOW j f FLAGGIR WORK VLuICLE SIGN LOCATION + WARIIINO FLAG Job #: Date: Jurisdiction: Right of Way Permit? Est. Start Date: Est. Duration: 106318403 11/30/16 Edmonds YES ❑ NO 8 Hours PRE -INSPECTION REPORT Address: 8223 208TH ST SW City / Zip: EDMONDS 98026 Customer: JAMES MAPOHN 310-213-7222 CUST PFjqj N PM / Insp: Kiara Hays/ A.Baunsgard 425- -020 PHONE NUMBER WORK DESCRIPTION: Construction Method Install a 50' scat 1-1/8 stub and 50' scat extension set a 425 meter. Tie-in might bePEor Open Trench ❑ 5 TW depending on where the crew ties In, it Is close to a transition fitting. Trenchless PLAT MAP: City of l:.Amands !is veCIUMng that we keep 5" Ihorlizontalll and the Vveirflcall sepairaflon between sewer water and storm, and specfficaUy 1.011 separaflon from the cty's water inrnafin bend. A425 MSA Uj 8223 (z > 10' Min from z 501-1/8" PE the back of Go scat extension/the water 1main PL PL SO- 1-1/8" PE scat stub ETPr — — — — — — — — — — — — — — - W 208th ST SW "I CL - - - - - - - - - - - - - - - - - - - - - - - - S -W - — — — — ----- QST 1-1/4 PE IP 4"STW IP 10'N of 1/16 SEC. LINE ? 5266-1963 3'W/E CL or 14'SCL 902558 Work Location Size of Cut Surface Type '11111I CL _20th-st sw— & 11� of CL ___83rdAVEM_ 3X7 Asghall 111111-111-111 . . ... 'N S of CL ...... ... ... ...... ... . . ... ........ &_ 'E W of 'N S of CL & 'E W of CL FLAGGERS # 2 MPH ❑ TROLLY LINES ❑ BUS STOP # ❑ METER HOODS # F OFFICERS # SPEED LIMIT ❑ TRAFFIC SIGNAL El ARTERIAL ❑ NO PARKS # n Commercial ❑ Altered Commercial ❑ Leak Repair Service Information E] Template Bar ❑Residential ❑ Altered Residential CP Work Diameter Meter EFV ❑0 Bollards 2.5" # ❑ Multi -Family ❑ Replacement Service ❑ Pothole ❑ 5/8" ❑ 250 0 1800 E] Bollards 4" # ❑ New Constr. Fj_ Main Maintenance Ej Extension ❑ 11/8" 425 2600 Stub ❑ Service Maintenance 11/4" ❑ 630 ❑ 10,000 ❑ FUEL LINE PERMIT NEEDED Extension ❑ Valve Maintenance ❑ 2" ❑ 1000 Fuel Line Length: F1 compete Sery Cut & Cap Mtr Loc: Fuel Line Diameter: Date of Request: Job number: Job address: PERMIT REQUEST FORM 12/21/16 106318403 8223 208th ST SW Project mgr; Andrew Baunsgard PM email: andrew.baunsgard@pse.com Estimated job start date: 01/30/16 Estimated job completion date: 02/03/16 Edmonds/ SNO CO. Zip: 98026 PM contact #: (425) 495-4465 Description of work to be performed: lortg= dcLSory cem,.-_ _ ........... ............ _. Pavement cut? -Yes ®No If yes, Dimensions of Cut: Length 3 Width 5ww _ m How many cuts? 2 Surface Type pavement Require trenching? Yes I-] No If yes, Dimensions of trench: Length 3 Width 5 Method of installation: Hole hog Traffic impact: Road closed Yes �✓ No Lane closed � Yes No How Many? It a m Shoulder closed ✓ Yes No Sidewalk closedYes No Emergency Contact: Andrew Baunsgard CeN NUmber: (425)495-4465 Depth 36 Direction? West