ENG20160513.pdf1215TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
t t
*PERM'" MUST BE POSTED ON JOBSITE*
STATUS': ISSUED ENG20160513
RIGHT OF WAI" PERM IT (6-EtIC)
Permit Number: ENG20160513 Expiration Date: 07/03/2017
Job Address: 18229 SUNSET WAY, EDMONDS Location: 18229 Sunset Way.
APPLI(ANT CONTRACTOR
PSE/Infras ource P SE/In fraso urce
GO Susan att: Sidick C/O Susan att Sidick
1660 Park Lane 1660 Park Lane
Burlington, WA 98233 Burlington, WA 98233
(425)457-6353
LICENSE, #: infrasl871 c2 EXP: 02/22/2017
JOB DLSCRIPTiON
Work area to 375'N c/I 184th ST SW and at the east edge of gravel on Sunset Way. To install gas service. 13X5 paving cut anticipated.
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: (OXO ) DURATION IN MONTHS. 0 FEE: $0,00 YEAR OF OVERLAY': 0 FEE $0„00
ALLEY., I 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 '
attorney fees by reason ofgranting this permit.
THE CONTRACTORIS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND A'CCEPTANCE0FTHE 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 DLkLrA-DIG (1-800-424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT.1326
24 HOUR NOTICEREQUHtED FOR ALLNSPECTION REQUESTS
APPLICATION APPROVAL
THIS APPLICATION IS NOTA PERMIT UNTIL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN
SPACE PROVIDED
Printed: Tuesda , Jantt ' 0;1 2017
111312-0
RELEASED BY DATE
FILE COPY ❑ INSPECTOR COPY APPLICANT COPY
• 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 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:OOam to 6:OOpm on weekdays and 10:OOam 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 fromthe 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.,
INSPECTIONS
• E -Engineering Final
PARTIAL INSPECTION DATE: INITIAL: NOTES`.
PARTIAL INSPECTION DATE: INITIAL: NOTES:
FINAL' INSPECTION APPROVED DATE: INITIAL:
ROW PERMIT NO.: I+ NGC21I OP-D6l 3
ISSUE DATE:
`,U JUGHT-OF-WAV CONSTRUCTION
PERMIT APPLICATION
DEC 2 2 2016
PROJECT NAME: 106318196 CONTACT: Sue Sidick ENGNEERINGIVI I
CONTRACTOR: PSE/Infrasource
Mailing Address: 1660 Park Lane, Burlington, WA 98233
State License #: INFRASI_871 C2
--..........m. .
Cit y N� ....
I$usiness License #. 019840
Phone #: 425-457-6353
Fax #:
Email #: Susan, Sid ick c❑i pse.corn
.
I,iabihtj Insurance I3onded
...��._..-__.._,
ADDRESS OR INTERSECTION OF CONSTRIJC'TION: 18229 Sunset Way
ROW WORK ASSOCIATED . WITH THE
FOLLOWING
OIL®WING TVi, OF PROJECT:
Commercial
• I �..�� _Subdivision City P�•oject Traffic Control (Only)
❑ Multi -Family ® Single Family ❑ Other
❑ EUC (PUD, VERILON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit'? ❑ Yes ® No
mm. . ............ -"1"--',--,-
'I""I"1111"- . . .... ............. . .
ANY ASSOCIATED PERMITS Fal ll# ENCi#
DESCRIPTION OF PROPOSED WORK (Be Specific) : Work area to 375'N c/I 184th ST SW
& at the east edge of gravel on Sunset Way. To install gas service
1 3x5 paving cut anticipated
...... .� �
YeaVAS SIREETOVERLAYIl) WITHIN THE LA�iFIVL -)YQRS Yh -� ............... _1_0 ........... 6.
_
-1111 1
PAVEMENT CUT: Yes No If es indicate. size of cut: x
® C__ y
CONCRETE CUT: F]Yes F-1No If yes, indicate size of cut: ---- X
APPLICANT TO READ AND SIGN
*Traffic control and public safety shall be in accordance with City regulations as required by the City
Engineer. Every f7agger 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.
SIGNATURE Susan Sidick� ��w,� °°�°r s°�°� 12/22/2016
�Yy�r DATE
Contractor or Agent
NO WORIC SHALL BEGIN PRIOR TO PERMIT ISSUANCE
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.
G. Alert affected residents and businesses.
7. Work to take place between 9 a.m. and 4 p.m.
8. Work area will be E of edge of gravel of Sunset Way &
375' NCL of 184th St SW.
9. If used, place NO -PARK signs 72 hours in advance
of the day that the work is to be done,
CHANNELIZATION
DEVICE SPACING
MPH7APER TANGE NTS
55!70 40 80
'35145.;_- 30 fi0
25/30...-...m..20 —__...
40
�Z-
'196
1
1
JOb#10G318
18229 Sunset Way Edmonds, WA
December 21st, 2016
Sheet 1 of 1 mitchell,peterson@pse,com
425-398-6071
RESIDENT(S) WILL BE INFORMED
OF POSSIBLE TEMPORARY
DRIVEWAY CLOSURE
I
#18229
~^ O "XIO
A0101f;,KWED AN
t � .
LAS o
ROAD N
WORK
184th St SW
LEGEND
_.-
------------ ._,_
28" TRAFFIC CONE_
BORE PIT
TRAFFIC FLOW
FLAGGER
V
fir. ,spm.
i
WORK VEHICLE
SIGN LOCATION
7
WARNING FI AG
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.
G. Alert affected residents and businesses.
7. Work to take place between 9 a.m. and 4 p.m.
8. Work area will be E of edge of gravel of Sunset Way &
375' NCL of 184th St SW.
9. If used, place NO -PARK signs 72 hours in advance
of the day that the work is to be done,
CHANNELIZATION
DEVICE SPACING
MPH7APER TANGE NTS
55!70 40 80
'35145.;_- 30 fi0
25/30...-...m..20 —__...
40
�Z-
'196
1
1
JOb#10G318
18229 Sunset Way Edmonds, WA
December 21st, 2016
Sheet 1 of 1 mitchell,peterson@pse,com
425-398-6071
RESIDENT(S) WILL BE INFORMED
OF POSSIBLE TEMPORARY
DRIVEWAY CLOSURE
I
#18229
~^ O "XIO
A0101f;,KWED AN
t � .
LAS o
ROAD N
WORK
184th St SW
Job #: 106318196
Date: 11/22/16
Jurisdiction: Edmonds
Right of Way Permit? 0 YES ❑ NO
Est. Start Date:
Est. Duration: 8 Hours
PRE -INSPECTION REPORT
MIP,5�.,���
Address:
18229 SUNSET WAY
City / Zip:
Edmonds 98026
Customer:
Gary Mrozek 425-749-8277
PM / Insp:
A. Baunsgord - 1
PHONE NUMBER
WORK DESCRIPTION: P_og§Lruction M
InstalWI-118 Scat stub ana 65 * Scat extension, 5eta?,501neter, Dare Lima has ok "ed Open Trench ❑
Meter location. Trenchless Q
PLAT MAP: W CL S G
r
y S T %J CSA% ,. f I
�g of- dal 1,— 'AF -PAPA -110" FAXI! I 4PL
M
w
I A`IiM3AI d (I
LLI
l�
n
I4 m a CAJ ® in 18229
(A M °`
w
r I " A250 MSA
r � ,
70' of SCAT
y� PPL 1-1/8" PE
w I
I �
I a STEEP' BRUSH HILL
N,
W A CL S
184TH ST SW
Work Location Size of Cut Surface Type
'N of CL 11 Si" 5 5 °E of CL 3x5 Gravel
'N S of CL
'N S of CL __ & E W of CL. .. _.
❑� FLAGGERS # 2 25 MPH ❑ TROLLY LINES ❑ BUS STOP # ❑ METER HOODS #
❑ OFFICERS # SPEED LIMIT ❑ TRAFFIC SIGNAL ❑ ARTERIAL ❑ NO PARKS #
nCommercial ❑ Altered Commercial ❑ Leak Repair tlo ❑ Template Bar
Q Residential ❑ Altered Residential ❑ CP Work Diameter Meter EFV ❑ Bollards 2.5" #
❑, Multl-Famlly ❑ Replacement Service ❑ Pothole ❑ 5/81' ❑� 250 ❑ 1800 ❑ Bollards 4" #
New Constr. ❑ Main Maintenance ❑ Extension 11/8" ❑ 425 Q 2600
❑ Stub ❑ Service Maintenance ❑ 11/4" ❑ 630 ❑ 10,000 ❑ FUEL LINE PERMIT NEEDED
❑ Extension F1 valve Maintenance ❑ 2" ❑ 1000 Fuel Line Length:
❑ Compete Sery Cut & Cap Mtr Loo: Fuel Line Diameter: