ENG20170020.pdfy 13D�
CITYf/,rr
1215TH AVENUE NORTH - EDMONDS, WA 98020
enC. tyr PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PE IMT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20170020
Permit Number: ENG20170020 Expiration Date: 08/07/2017`
Job Address: 7717 196TH ST SW, EDMONDS Location`. 7717 196TH ST SW
GO KALLEN RANDALL
P.O. BOX 1107
EVERETT, WA 98206
SNOHOMISH COUNTY P
C/O KALLEN RANDALL
P.O 'BOX 1107
EVERETT, WA 98206
(425) 670-3216
LICENSE 4 UBI:313'005
We will need to block the most northern lane of 196th st SW for a;few hours while we install a Gang -Operated switch' on the existing
pole just west of 7717196th ST SW
ASSESSED VALUE: $0.;00 PROPERTY AREA: 0
SIDEWALK: ( OXO) DURATION IN MONTHS: 0 FEE: $0,00 STREET DISRUPTION TRENCH CUT: ( 0 X 0 )
PARKING: ( 0X0) 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 stales 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 of its departments or employees, including but not limited to the defense of any"legal proceedings including defense costs and
attorney fees by reason ofgranling this permit.
THE CONTRACTORIS'RESPONSIBLEFOR WORKMANSHIP'AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE O F 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.
THIS APPLICATION IS NOT
Ra
FILE COPY
CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANYEXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT. 1326
24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQUESTS
SPACE PROVIDED r
INSPECTOR COPY
EIPTIS ACKNOWLEDGED IN
e day Xebruarit 07 2017
217/2017
APPLICANT COPY
• Restore ROW to City standards
• Restore Landscape to dike or better, conditions.
• Alert affected residents and/or businesses prior to work start.
• Conform to approved working drawings and Traffic Control plan.
•, Maintain erosion & sedimentation control. Keep street clean.
• Call for requiredinspections as noted.
• Traffic Control per approved plan and MLITCD 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 fromtemporary 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 othertimes 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 from the issuance ofthis pert-tit. 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-Traffic' Control'
• E-Engineering Final'
PARTIAL INSPECTION DATE: INITIAL: NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: IMTIAL:
' 1)
14v(
R. E C rZ YAG 0
JAN, 18 2017
F)EVELON�ENT SEII=',"�.13) ROW PERMIT NO.: ENS:` P0 �J-cv�b
ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME:
CONTiUCTOk- — --
Mailing Address:
State License
6ty Business Uic - e- —n s_e"
ADDRESS OR INTERSECTION OF CONSTRUCTION:
CONTACT: o
Phone
. .......... . ----- -------
Faxih
.......... . . . . ................. . .... ...... . ..... .
Email 9:
Liability Insur nee Bonded
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
Project Traffic Control (Only)
. City, w....--.......-....._._-
............ . ... .. ... . ........... . ....... . ..........
Commercial _7 --7-1—s
❑ Multi -Family El Single Family [
.] Other
❑ EUC (PUD, VERIZON, PSI,,
COMCAsT, OVWSD):
Is this permit part of a. blanket permit? F1 Yes r No
ANY ASSOCIATED PERMITS? BLD,, 111111 EN04
DESCRIPTION OF PROPOSED WORK (Be Specific) i y
WAS STREET OVERLAYED WITHIN THE LAS.
........ . ..... — — -------- - ... T-F fVE
EARS YES � NO 0 Year:
PAVEMENT CUT: 71 Yes [E No If yes, indicate size of cut: x
CONCRETE CUT: F-1 Yes 0 No If yes, indicate size of cut:
RIGHT-OF-WAY DURATION
AREA TOTAL
CLOS(NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF X LF SF
...........
--- Alley 72 Hrs + .. � � .m
IAF LF SF
Wonum
Parking 72 Hrti +a��...... _ ... LF ...._ X _ _...... ..L.. .
F 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 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 , r !:_. DATE i
Contractor or Agent
NO WORD SHALL BEGIN PRIOR TO PERMIT ISSUANCE
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T&D Assembly Unit
Switch, 600A 1 30 Gang -Operated
Primary Deadend Above - Pole Top Framing
W0201 X0201
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S&C 15kV Switch
1211117713
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REV. 7
MAY 4, 2014
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