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ENG20170093-APPROVED PERMIT.pdfrd "ITY'OF EDMONDS 121 5TH AVENUE NORTH - EDM ONDS, WA 98020 lrr�_` t a9 PHONE: (425) 771-0220 - FAX: (425) 771-0221 *PE IT' MUST BE POSTED ON JOBS TEi US: ISSUED ENG20170093 Job Address: 23811 79TH AVE W EDMONDS PSF/In fras ource C/O Susan att: Sidick 1660 Park, Lane Burlington, WA 98233 Work area is approx 19'W c/I of 79th Ave W & 162'S and cap e)asting service at 23819 79th Ave W. St SW . 2'3x5 paving cut anticipated. To install A SSr,i,'0 VALUE: $0,00 PROPERTY AREA 0 SIDEWALK: ( OXO) DURATION IN MONTHS: 0' FEE: $0,00 STREET DISRUPTION TRENCH CUT: ( 3 X 5 ) LARKING:'' ( 0X0') DURATION IN MONTHS: 0 FEE $0;00 YEAR OF OVERLAY: 0 FEE: $0;00 ALLEY: t 0X0) DURATION IN MONTHS: 0 FEE:, $6,,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 of its departments or employees, including but not limited to the defense of any legal proceedings including defense costs and attorneyfees by reason ofgranting,thispermit, THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FORA PERIOD O'FONEYEAR FOLLOWING,THE FINAL ' INSPECTION AND ACCEPTANCE OF THE W ORK 6;'.. Traffic Control and public safety shall be in accordance with City regulationsas required by the City Engineer. Every flagger.. must be trained as required by (WAC) 296-155-305 and must have certification verifying completion ofthe required' training in their possesioni 0. 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 ofthe workday- NO'EXCEPTIONS. • Three sets ofconstruction drawings'ofproposed work are required with the permit application. CALL DIALrA-DIG(1-800-424-5555) BEFORE ANY EXCAVATION' CALL FOR INSPECTION (425) 771-0220 EXT. 1326 24 HOUR NOTICEREQUIRED"FOR ALL INSPECTION 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: Monda i Mu " 08, 2017 RELEASED BY DATE FILE COPY INSPECTOR COPY ❑ APPLICANT COPY ExpirationDate: 11'/08/201 Location: 23811 79TH AVE W CONTRACTOR PSE/Infrasource C/O Susan att: Sidick 1660 Park Lane Burlington, WA 98233 (425)"457-6353 LICENSE 4: infras187Ic2 EXP: 02/22/2019 St SW . 2'3x5 paving cut anticipated. To install A SSr,i,'0 VALUE: $0,00 PROPERTY AREA 0 SIDEWALK: ( OXO) DURATION IN MONTHS: 0' FEE: $0,00 STREET DISRUPTION TRENCH CUT: ( 3 X 5 ) LARKING:'' ( 0X0') DURATION IN MONTHS: 0 FEE $0;00 YEAR OF OVERLAY: 0 FEE: $0;00 ALLEY: t 0X0) DURATION IN MONTHS: 0 FEE:, $6,,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 of its departments or employees, including but not limited to the defense of any legal proceedings including defense costs and attorneyfees by reason ofgranting,thispermit, THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FORA PERIOD O'FONEYEAR FOLLOWING,THE FINAL ' INSPECTION AND ACCEPTANCE OF THE W ORK 6;'.. Traffic Control and public safety shall be in accordance with City regulationsas required by the City Engineer. Every flagger.. must be trained as required by (WAC) 296-155-305 and must have certification verifying completion ofthe required' training in their possesioni 0. 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 ofthe workday- NO'EXCEPTIONS. • Three sets ofconstruction drawings'ofproposed work are required with the permit application. CALL DIALrA-DIG(1-800-424-5555) BEFORE ANY EXCAVATION' CALL FOR INSPECTION (425) 771-0220 EXT. 1326 24 HOUR NOTICEREQUIRED"FOR ALL INSPECTION 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: Monda i Mu " 08, 2017 RELEASED BY DATE FILE COPY INSPECTOR COPY ❑ APPLICANT COPY • RestoreBROW to City standards • RestoreLandscape 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. • Confonnto 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 fromthe noise limits of ECC Chapter 5.30 only during the hours of 7:00amto 6:00pm on weekdays and«10:00am 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 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 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. INSPFCTIONS E -Engineering Final PARTIAL INSPECTION DATE: INITIAL: NOTES: - PARTIAL INSPECTION DATE: INIITIAL:� NOTES: FINAL INSPECTION APPROVED DATE: INITIAL: . 0 kIS�" R ,J H 2017 ROW PERMIT NO.: ENG ISSUE DATE: RIGHT-OF-WAY CONSTRUCTION PERMIT APPLICATION PROJECT NAME: 109103726 CONTRACTOR: PSE/Infrasource Mailing Address: 1660 Park Lane, Burlington, WA 98233 State License #: INFRASL871 C2 City Business License #: NR -023614 CONTACT: Sue Sidick Phone #: 425-457-6353 uuuu. Fax #: Email #: Susan.Sidick@pse.com El Liability Insurance Bonded ADDRESS OR INTERSECTION OF CONSTRUCTION: 23819 & 23811 79th AVE W ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT: Commercial Subdivision LJ City Project LJ Traffic Control (Only) ❑ Multi -Family ❑X Single Family ❑ Other ❑ EUC (PUD, VERIZON, PSE, COMCAST, OVWSD): Is this permit part of a blanket permit? ❑ Yes FAI No ANY ASSOCIATED PERMITS? I BLD# ENG# DESCRIPTION OF PROPOSED WORK (Be Specific) : WORK AREA IS APPROX 19' w c/L of 79TH ave w & 162' s c/L of 238TH st sw 2 3X5 PAVING CUTS ANTICIPATED. To install twin service and cut and cap existing service at 23819 79 AVE W. WAS STREET OVERLAYED WITHIN THE LAST FIVE (5) YEARS? YES NO Year:109� PAVEMENT CUT: ® Yes ❑ No If yes, indicate size of cut: 3 CONCRETE CUT: ❑ Yes ❑ No If yes, indicate size of cut: x 5 APPLICANT TO READ AND SIGN yry k auann iUNUA9M *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 "" "'a 4/72017 r�r",`�"' r wry„��a�wx.uw"�%r5 �u���� SIGNATURE �_� DATE Contractor or Agent NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE RESIDENT(S) WILL BE INFORMED OF POSSIBLE TEMPORARY DRIVEWAY CLOSURE IT......ZEG E N D ........ m. ............................ .... ® 28"TRAFFICCONE BORE PIT TRAFFIC FLOW FLAGGER WORKVEHICLE SIGN LOCATION WARNING FLAG a DEVICE SPACIN G�� PER EVERETT STD's - - - ANGEINT ET MPH (TAPER (FT) ">( .........,,,,�....2.020 ........m........._ 25 20 25 —3y0 20 30 .............. 6NOMOW40 Apel X fro I I:u I, f9f .✓�Tik�. ,: J,e�l 4�. die, �J �k J�� L a, j31 a� 238TH ST Notes: = 1. All signs and spacing to conform to the MUTCD 14 14 b 4 ` and City of Edmonds standards. 2. All sidewalks, driveways, exits and egresses :Zi shall be completely clear unless otherwise indicated. a 3, Channelizin devices are 28" traffic cones, 9 _ 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 Y1F.. 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 approx. 19' W of CIL of 79th Ave W Ret cM'NGPIT & 162'S of CIL of 238th ST SW. a DEVICE SPACIN G�� PER EVERETT STD's - - - ANGEINT ET MPH (TAPER (FT) ">( .........,,,,�....2.020 ........m........._ 25 20 25 —3y0 20 30 .............. 6NOMOW40 Apel X fro I I:u I, f9f .✓�Tik�. ,: J,e�l 4�. die, �J �k J�� L a, j31 a b; 100' 238TH ST SW Gr��u Notes: 14114 Q 1, All signs and spacing to conform to the MUTCD 9 P 9 W20-1 " m 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, USE MAXIMUM AVAILABLE 4, Sign size can be a minimum of 48" x 48" and SPACE FOR SIGNS ry shall not obstruct pedestrian access. 5, Crew is required to leave a minimum of 11' for Co —. traveling lane width. 6. Alert affected residents and businesses. P1w 7. Work to take place between 9 a.m. and 4 p.m. 8. Work area will be approx. _' E of CIL of 791h Ave W n' a p RESIDENT(S) WILL BE INFORMED & 162'S of CIL of 238th ST SW. L ' ° OF POSSIBLE TEMPORARY LEGEND DRIVEWAY CLOSURE I� 28'TRAFFICCONE BORE PIT TRAFFIC FLOW ............... DEVICE SPACCNIS FLAGGER PER EVERETT STD's TAPER Ti TAN,C°s.2,O WORK VEHICLE 20.. wFT 20 N SIGN LOCATION .. .. .. �„�, .......n. ...............e. Z5 ZO Z5 + WARNING FLAG _ 30 20A 3l)...... .. ------------ 2n u... _........ Job #: t" .... Date: Jurisdiction: Right of Way Permit? lD YES NO Est. Start Date: Est. Duration: I 5TL PRE -INSPECTION REPORT Address: City/Zip: Customer: u�r wr+ory"'_ t 3u°OW PM I Insp, P' !, .. ........... .......,M,�.��.... PHONrrvvMaea Open Trench ❑ t, 0Trenchless ❑ i � 16 tfilr� "'i - 8ofCL N S of CIL ❑ FLAGGERS # .. _" ............................. MPH.. ❑ OFFICERS # IT [W I mmardal ❑ Altered Commercial 1 Residential�� Agter(M Residential E] Multi -Family Replacement Service ❑ New Constr. ❑ Main Maintenance ❑ Stub J] Service Maintenance ❑ Extension ❑ Valve Maintenance ❑ Compete Sery ❑ Cut & Cap A ❑ METER HOODS # ❑ NO PARKS # �.^. ._. u.�. ❑ Template Bar EFV 800 ® Bollards 2.5" # 600 ❑ Bollards k" # e ❑ 10,000 ❑ FUEL LINE PERMIT NEEDED Fuel Line Length: Fuel Line Diameter: 'E W of ❑ry TROLLY LINES El BUS STOP # ❑ TRAFFIC SIGNAL ❑ ARTERIAL ❑ Leak Repair giff—v ormoa ❑ CP work Diameter Met El Pothole ❑0/8" � ❑ Extension L,� 11/8" ❑ 425 ❑ 11/4" ❑ 630 ❑ 2" ❑ 1000 A ❑ METER HOODS # ❑ NO PARKS # �.^. ._. u.�. ❑ Template Bar EFV 800 ® Bollards 2.5" # 600 ❑ Bollards k" # e ❑ 10,000 ❑ FUEL LINE PERMIT NEEDED Fuel Line Length: Fuel Line Diameter: Date of Request: 03/16/17 Job number: 109103726 Job address: 23811 79 Ave W City: Edmonds Zip: Project mgr: Gayle Plaisance PM contact #: (253) 617-6013 PM email: gayle.plaisance@pse.com Estimated job start date: 04/07117 Estimated job completion date: 04/28/17 Description of work to be performed: -Re.� e-ga-a.bcxe-add - ,.... See-attact e . tela . sp,ecifi+c..Ira i. pact . _.............._..._.. Pavement cut? Yes FJNo If yes, Dimensions of Cut: Length 3' Width-- 5' How many cuts? 2 Surface Type asphalt Require trenching? ❑Yes No If yes, Dimensions of trench: Length Width Depth Method of installation; Traffic impact: Road closed OYes ONo Lane closed Flyes 0 No Shoulder closed F es O No Sidewalk closed Fyes 0 N Emergency Contact: Mike Blood Cell Number: L) 864-6164 How Many? 1 Direction? south CO cli 1' 149 IF -2- t I CN 3.51 .0 cl> CV 10 CN