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ENG20170006.pdf01° D'iI CITYcry EDMONDS 121 5TH AVENUE NORTH'- EDMONDS, WA 98020 PHONE: (425) 771-0220 - FAX: (425) 771-0221 *PERMIT MUST BE POSTED ON JOBS TE* STATUS: ISSUED ENG20170006 Permit Number: ENG20170006 Expiration Date: 07/13/2017 Job Address: 21730 95TH AVE W, EDMONDS Location: 21730 95th Ave W PSE/Infrasource PSE/Infrasource C/O Susan att: Sidick C/O Susanatt: Sidick 1660 Park Lane 1660 Park Lane Burlington, WA 98233 Burlington, WA 98233 (425)457-6353 LICENSE #: infrasl87lc2 EXP: 02/22/2017 area is approx 130'N c/l of 218th ST SW and 14 W c/1 of 95th Ave W. Tp install gas service. 13X5 in cut dirt anticipated ASSESSEDVALUE: $0,00 PROPERTY AREAr 0 SIDEWALK: (OXO) DURATION IN MONTHS: 0 FEE: $0:00 STREET DISRUPTION TRENCH CUT: ( 3 X 5 ) PARKING: (°0X0;) DURATION IN MONTHS: 0 FEE: $0,00 YEAR OF OVERLAY: '0 FEE: $0.,00 ALLEY: ( OX0) DURATION IN MONTHS: 0 FEE: $0.00 INDEMNITY- The Applicant has signed an application which stales 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 of its 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 RESPONSIBLEFOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONEYEAR FOLLOWING THEFINAL INSPECTION AND ACCEPTANCE OF THEW ORK • 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 RE(JUESTS _ APPLIGATION APPROVAL, THIS APPLICATION IS NOTA PERMITUNTTL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPTIS ACKNOWLEDGED IN SPACE PROVIDED; Printed, rida ;jantra , ,1:1 2017 clhn lr a Wa Gairo( Q&17 RELEASED BY DATE ❑ FILE COPY F_� INSPECTOR COPY ❑ APPLICANT COPY 0, Restore ROW to City standards 0 Restore Landscape to like or better conditions. 0 Call for locates of underground utilities prior to any excavation, 0 Alert affected residents and/or businesses prior to work start. 0 Conform to approved working drawings and Traffic Control plan. 0= 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 controlrequirements. • 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. 0 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:OOpm on weekdays and 10:00am and 6:OOpm 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. 0 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 ofthis pempt. 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. 0 E -Engineering Final PARTIAL INSPECTION DATE: INITIAL: NOTES: PARTIAL INSPECTION DATE: INITIAL: NOTES: FINAL INSPECTION APPROVED DATE: INITIAL; /'1;C, i, 3� 11 N re V4 P v ttv . {+ I N' r -0 11�4vn 4.ep�m ROW PERMIT NO.: ENG 1 mj- avo('Iel ISSUE DATE: RIGHT-OF-WAY PERMIT APPLICATION PROJECT NAME: 106319525 CONTRACTOR: PSE/Infrasource Mailing Address: 1660 Park Lane, Burlington, WA 98233 _ State License #: �...�.INFRASL87.____ .............._ 1 C2 City Business License#: NR -019840 CONTACT: Sue Sidick Phone #: 425-457-6353 .. -- Fax #: wn 2017 )slom Email #: Susan,Sidick@pse.com -.....:...._-....-.--- ..�..... � . .., � ww �w��w�.............. Liability Insurance Bonded ADDRESS OR INTERSECTION OF CONS'T'RUCTION: 21730 95 AVE W ROW WORK �.. ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT: Corn..... _m ..._ A. _._.�.._ __. ._..�._�..... .. rnereial.Subdivis'i'on.City ProjectIT Traffic.._ Control (Only) ❑ Multi -Family ❑X Single Family Q Otber ❑ EUC (PUD, VERIZON, PSE, COMCAST, OVWSD): Is this permit part of a blanket permit'? ❑ Yes ® No [",_. ....... ..... ANY ASSOCIATED PERMITS? BLD# ENG# ... --- ......-.. .� -- .. I DESCRIPTION OF PROPOSED WORK (Be Specific) : Work area is approx 130'N c/l of 218th ST SW and 14'W c/1 of 95th AVE W. To install gas service 1 3x5 in dirt anticipated. IIF AS STREET OVTRLAYED WITHIN THE LAST FIVE (5) YEARS? YFS � ] No NO n Year: 106&1 PAVEMENT CUT:, Yes ®No If yes, indicate size of cut: „mmmm mmm CONCRETE CUT: ❑ Yes ❑ No If yes, indicate size of cut: x RIGHT-OF-WAY DURATION CLOSURE AREA TOTAL (NUMBER OF MONTHS) Sidewalk 48 Hrs + LF X LF SF Alley�� LF__ _ X L.. 72 Hrs + F SF m . Parking 72 Hrs + LF X LF SF 'I 00000000L __ 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 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 01/04/2017 SIGNATURE a .10900AVaee30Oro� DATE Contractor or Agent NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE d �1� ry Y 4 — L 4v I,, RESIDENT(S) WILL BE INFORMED OF POSSIBLE TEMPORARY DRIVEWAY CLOSURE 21730 CHANNEL IZATION DEVICE SPACING ..... 46T J5/70 40 a0 5 ...._...20 TRAFF� ...........LEGEND IC CONE BORE PIT TRAFFIC FLOW �q.,nkz{nF CT, MJF. FX Wr"KA R I a,+ �► N(94aOf, n,4ON G Y C O NtAtliMUG YC„M1,k"J J,. irx-'8Ni 0 II � 0 1i1�1f ra ]qJ7 AD I' 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 14' WCL OF 95TH AVE W & 130' NCL of 218TH ST SW. 9. If used, place NO -PARK signs 72 hours in advance of the day that the work is to be done, PUGET SOUND ENERGY Jab4106319525 21730 95TH AVE W EDMONDS, WA JANUARY 4, 2017 Sheet 1 of 1 sally, berg man@pse.com (425) 398.6003 d �1� ry Y 4 — L 4v I,, RESIDENT(S) WILL BE INFORMED OF POSSIBLE TEMPORARY DRIVEWAY CLOSURE 21730 CHANNEL IZATION DEVICE SPACING ..... 46T J5/70 40 a0 5 ...._...20 TRAFF� ...........LEGEND IC CONE BORE PIT TRAFFIC FLOW �q.,nkz{nF CT, MJF. FX Wr"KA R I a,+ �► N(94aOf, n,4ON G Y C O NtAtliMUG YC„M1,k"J J,. irx-'8Ni 0 II � 0 1i1�1f ra ]qJ7 AD I' 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 14' WCL OF 95TH AVE W & 130' NCL of 218TH ST SW. 9. If used, place NO -PARK signs 72 hours in advance of the day that the work is to be done, rffl�k 112 A250 MSA 40' SCAT 1-1/8" PE EXTENSION P/L 0 16' SCAT 1-1/8" PE STUB en 00 00 CL �01 gill LU Ln MX I �f 4, pd J F'44 u t A � --,v:,-PAA -1,6/u, c'� 1,4 0-7 It, /7 If 218TH PL SW I Size of Cu � Surface Type —JIQ- W of CIL __2j4th_atSW____ PRE -INSPECTION REPORT Ay" j Job #: 106319525 of CL Date: 12/28/16 Address: 21730 95TH Ave W Jurisdiction: Edmonds City / Zip: Edmonds Right of Way Permit? F] YES E] NO Customer: Anthony 425 686-2477 FLAGGERS * 1 26 MPH Est. Start Date: F1 PM Insp: A. Baunsgard Est. Duration: OFFICERS # SPEED LIMIT El TRAFFIC SIGNAL PHONE NUMBER WORK DESCRIPTION: R commercial F/I Altered Commercial F1 Construction Method Install 56' 1-1/8 complete service and seta 250 meter on the North-East corner, F1 New Construct ❑ Main Extension Diameter . . ...... ....... . . .... . ..... ❑ Existing Pothole 0 5/8" Ej 250 E] . ..... .. ...... ....... . .. ❑ Open Trench Bollards 2] 1118" E] 425 (3 1800 E] 2# ❑ Trenchiess 113 rffl�k 112 A250 MSA 40' SCAT 1-1/8" PE EXTENSION P/L 0 16' SCAT 1-1/8" PE STUB en 00 00 CL �01 gill LU Ln MX I �f 4, pd J F'44 u t A � --,v:,-PAA -1,6/u, c'� 1,4 0-7 It, /7 If 218TH PL SW I Size of Cu � Surface Type —JIQ- W of CIL __2j4th_atSW____ 'N S of CL of CL N S of CL & 'E W of CL FLAGGERS * 1 26 MPH ❑ TROLLY LINES F1 BUS STOP # ❑ OFFICERS # SPEED LIMIT El TRAFFIC SIGNAL ❑ ARTERIAL R commercial F/I Altered Commercial F1 manifold Service Informationi F1 Residential ❑ Altered Residential Main Extension Diameter Meter EFV Pressure ❑ Multi-Famlly ❑ Replacement Service ❑ Pothole 0 5/8" Ej 250 E] 775 M 6"wc ❑ New Constr. E] Main Maintenance ❑ Bollards 2] 1118" E] 425 (3 1800 E] 2# ❑ Stub ❑ service maintenance ❑ 111411 ❑ 630 ❑ 2600 Extension ❑ Valve Maintenance ❑ 2" ❑ 1000 ❑ 10,000 ❑ Compete Sery ❑ Cut & Cap Mtr Loc: F] 4" E] IMO ❑ NA [:] METER HOODS # F1 NO PARKS # F] Template Bar E] Bollards 2.5" # Ej Bollards I" # El FUEL LINE PERMIT NEED Fuel Line Length: Fuel Line Diameter: Ai, I