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ENG20170039.pdfl to /j 4 (,".41TY OF EDMONDS 121 5TH AVENUE NORTH - EDMONDS, WA 98020 tatPHONE: (425) 771-0220 - FAX: (425) 771-0221 e. *PERMIT MUST BE'POSTED ON JOBSI"'E* STATUS: ISSUED ENG20170039 RIGHT OF WAY PERM IT (6-EIIC) Permit Number: ENG20170039 Expiration Date: 08/07/2017 Job Address: 22004 92ND AVE W, EDMONDS Location: 22004 92ND AVE W APPLICANT PSE/Infrasource CONTRACTOR PSE/Infrasource 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 #: infrasl87l c2 EXP: 02/22/2017 Work area is approx 100' S 1 3x cut in dirt anticipated. ASSESSED VALUE: $0;,00 PROPERTY A SIDEWALK: ( OXO) DURATION IN MONTHS: 0 PARKING. ( 0X0) DURATION IN MONTHS: 0 ALLEY ( 0X0 1 ___DURATION IN MONTHS: 0 to install; gasservice 13x5 paving cut anticipated and 0 FEE: $0;00 STREET DISRUPTION TRENCH CUT: ( 3 X 5 ) FEE $0,,00 YEAR OF OVERLAY: 0 FEE: $0,00 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 may be made against the City of Edmonds or any ofits departments or employees, including but not limited to the defense ofany legal proceedings including defense casts and attorney fees by reason ofgranting this permit. THECONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FORA PERIOD OFONEYEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THEW ORK a 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 SPACE PROVIDED.. Printed: Tuesday, Februa 07, 2017 U)aelAw4215 : /7/ZO17 RELEASE BY DATE [:], FILE COPY F-1 INSPECTOR COPY E] 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. 4 Call for required inspections as noted. •I Traffic Control per approved plan and MUTCD. Refer to City of Edmonds traffic control, requirements. 0: 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 constructionactivity are exempt fromthe noise Units of ECC Chapter 5.30 only during the hours of 7:00amto 6:00pmon weekdays and 10:00amand 6:00pmon 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 ofhis '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 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. • &Engineering' Final PARTIAL INSPECTION DATE: INITIAL: NOTES: PARTIAL INSPECTION DATE: INITIAL: NOTES: FINAL' INSPECTION APPROVED DATE: INITIAL: <)f EVtq0 11 O RECEIVED E F, 0.12017 BUILDING ROW PERMIT NO.: ENG_ l ISSUE DATE: RIGHT-OF-WAY CONSTRUCTION PERMIT IT APPLICATION PROJECT NAME: 106320178 CONTRACTOR: PSE/Infrasource Mailing Address: 1660 Park Lane, Burlington, WA 98233 State License #: INFRASL871 C2 City Business License #: NR -019840 CONTACT: Sue Sidick Phone #: 425-457-6353 Fax #: Email #: Susan.Sidick@pse.com El Liability Insurance El Bonded ADDRESS OR INTERSECTION OF CONSTRUCTION: 22004 92nd AVE W ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT: Commercial Subdivision City Project Ll Traffic Control (Only) ❑ Multi -Family ❑X Single Family ❑ Other ❑ EUC (PUD, VERIZON, PSE, COMCAST, OVWSD): Is this permit part of a blanket permit? ❑ Yes ❑�k No ANY ASSOCIATED PERMITS? BLD# ENG# DESCRIPTION OF PROPOSED WORK (Be Specific) : Work area is approx 100' S C/1 of 220th ST SW & 6'W & 8'W c/I of 92nd AVE W to install gas service 1 3x5 paving cut anticipated and 1 3x5 cut in dirt anticipated WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES NO ❑ Year: 106b PAVEMENT CUT: N Yes ❑ No If yes, indicate size of cut: 3 x 5 CONCRETE CUT: 0 Yes ❑ No If yes, indicate size of cut: x_ RIGHT-OF-WAY DURATION AREA TOTAL CLOSURE (NUMBER OF MONTHS) Sidewalk 48 Hrs + LF X LF SF �.Al1ey..72...Hrs + ��n............_� LF X LF SF Parking 72 Hrs + LF— X LF 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. qua m.vntia.M aar,� M�pnrR true M€+wrgp�, ou.8trex uu SIGNATURE Susan Sidic{( � � � �Y�s °� �s DATE 02/0�/20�7 Contractor or Agent NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE 220TH ST SW ........... -W..... _,---. ...... 2oB� ............... LEGEND 28' TRAFFIC CONE BORE PIT TRAFFIC FLOW I n FLAGGER WORK VEHICLE SIGN LOCATION WARNING FLAG PUGET SOUND ENERGY Job#106320178 „r it, "` 33004 92ND AVE W EDMONDS, WA January30, 2017 Sheet 1 of 2 sally.bergman@pse.com NB (425) 398-6003 N a Z Z b�4 4t, u t *>Y_ V 13 1 VIM x� VOW ifE-,_,............... -- __. oo .._-.2ao .W_.-...... 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 18' ECL of 92ND AVE W & APPROX. 100' SCL of 220TH ST SW. 9. If used, place NO -PARK signs 72 hours in advance of the day that the work is to be done. INA G 116111C, 114' L"4110,01 t 5'&7N Z- M AI,_10N DSVI E SPACING E i�krfi1ANGSt�Yf40 _ 80 30 80 22 _ 40F NIMMIMIN�rMMM1NNr14Y'NI� 200' W a. i%l W20.1 tw207A 22004 y � Nf3-4 V LEGEND 28' TRAFFIC CONE BORE PIT b TRAFFIC FLOW FLAGGER '',.......'... WORK VEHICLE H SIGN LOCATION WARNING FLAG �I M Notes: 1. All signs and spacing to conform to the MUTCD V and City of Edmonds standards. V 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 6'-12' WCL of 92ND AVE W & APPROX. 100' SCL of 220TH ST SW. 9. If used, place NO -PARK signs 72 hours in advance of the day that the work is to be done. 200' F_ 200'r— 200' MIA ,IrATBOON DESPACING M:PN LWY r5170 40 1 80 36 1 80 25/30 20 40 Job #: 106320178 Date: 1/19/17 Jurisdiction: Edmonds Right of Way Permit? 0 YES F] NO Est. Start Date: Est. Duration: WORK PESq_RIPTION. PRE -INSPECTION REPORT Address: 22004 92nd Ave W * � YAIk9 City / Zip: Edmonds 98020 Customer: Jared ---206227-4071 GUST PHUNL NUMBER PM / Insp: A.Baunsgard 425-495-4465 PHONE NUMBER Construction Method Open Trench E-] Upgrade to a 54-1-118 Scat Stub and 55'1-118 PLA TExtension. Set a A250 meter at 6" WC, Trenchless E] PLAT MAP: 220th ST SW o &)c vr:�Pwlor-Ttq),� A, V-00, Wfir U- A 1,AJ P LAP A N -.j , ""j( �4t t-4 t) 0 J.0 'rAl-, A250 MSA + �EPAA?oice,) (-fd1ev'Y1 0, _t 11, j ,..j.I 1� 0 P SVT I"U 5,P), V- BUZC� (A& -r, MX, 54'1-1/8" PE SCAT STUB 55'1-1/8" PE PLAT EXTENSION qa S f CIL N S of C L Work Location RIVV -"E 'E W f CIL .. . ...... 'E W of CIL• . .... . ..... . .... Size of Cut 3x5 Surface Type ........ .................. Dirt A_sPha1t__, FLAGGERS # 2 26 MPH ❑ TROLLY LINES ❑ BUS STOP # ❑ METER HOODS # ❑ OFFICERS.!_ SPEED LIMIT ❑ TRAFFIC SIGNAL Ej ARTERIAL El NO PARKS # ❑ Commercial ❑ Altered commercial F] Leak Repair Service Information E] Template Bar ❑ Residential Altered Residential F1 CP Work Diameter Meter EFV E] Bollards 2.5" # ❑ Multi -Family E] Replacement Service F1 Pothole ❑ 5/8', 250 ❑ 1800 [j Bollards 4" # F] New Constr. E] Main Maintenance ❑ Extension ❑ 11/8" ❑ 425 0 2600 Stub F1 service maintenance ❑ 11/4" ❑ 630 ❑ 10,000 E] FUEL LINE PERMIT NEEDED Extension F1 Valve Maintenance E) 2" El 1000 Fuel Line Length: Compete Sery r_j Cut & Cap Mtr Loc: Fuel Line Diameter: