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ENG20170098-ISSUED.pdf0 1' tart CITY OF 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 ° ENG20170098 'r GI 1111L1N UI I IUGI'.L1N%JZ,V 1 /:VV70 P.1L11 If aLlUl I"ULU. 1V/,1 V/G V.I / Job Address: 23914 84TH AVE W,;EDMONDS Location: 23914 84TH AVE W PSE/Infi-as O Urce CONTRACTOR PSE/I n fraso urc e C/O Susan'att: Sidick C/O Susan att: Sidick 1660 Park Lane 1660 Park Lane Burlington, WA 98233 Burlington, WA 98233 (425)'457-6353 LICENSE #: infras1871 c2' EXP: 02/22/2019 i orK area is approx I /:), r of 84th Ave W to install gas service. 13x5 paving cut For new single family home constructed underBLD20161113. ASSESSED VALUE:'' $000 PROPERTY AREA: 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: ( 0X0 ) DURATION IN MONTHS: 0 FEE $000 IADEMNVITY The Applicant has signed an application which states he/she holds the City ofEdmmnds 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 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 OFTHEWORK. • 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 posses'ion. • 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 DIALrA=DIG (1-800-424-5555) BEFORE ANY EXCAVATION' CALL FOR INSPECTION (425) 771-0220 EXT. 1326 24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQUESTS XPPLICATION 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: M1 Ilt1a April 111,2017 RELEASED BY V DATE FILE COPY F-] INS PECTOR COPY F-] APPLICANT COPY a Restore ROW to City standards • Restore Landscape to like or better conditions. r Call for locates of underground utilities. prior to any excavation. • Alert affected residents and/or businesses, prior to work start. • "Coln—form t10 a rord wotkr tlrtswrn �s and 1"�allio fntrl tan pp........... .. P ....... _..,,, p .._ m� 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 control requirements. • Applicant shall repair -/replace all damage to utilities or fi•ontage 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 7:00amto 6:00pm on weekdays and 10:00am and 6:00pm 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. • 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 permit. Issuance ofthis 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. • lsEngineering Final PARTIAL INSPECTION DATE: INITIAL: NOTES: PARTIAL INSPECTION DATE: INITIAL: NOTES: FINAL INSPECTION APPROVED DATE: INITIAL: RECEIVED MAI? 2 2 2017 MAR 2 2 2017 BUIL1111"'131NG ROW PERMIT NO.: ENG Xn — oo ct ISSUE DATE: RIGHT-OF-WAY CONSTRUCTION PERMIT APPLICATION PROJECT NAME: 106321790 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 Fax #: Email #: Susan.Sidick@pse.com Liability Insurance ❑ Bonded ADDRESS OR INTERSECTION OF CONSTRUCTION: 23914 84th AVE W ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT: Commercial Subdivision City Project Traffic Control (Only) ❑ Multi -Family ❑X Single Family ❑ Other ❑ EUC (PUD, VERIZON, PSE, COMCAST, OVWSD): Is this permit part of a blanket permit? ❑ Yes © No ANY ASSOCIATED PERMITS? BLD# ENG# __.......... .._..�. DESCRIPTION OF PROPOSED WORK (Be Specific) : Work area is approx 175'N C/1 of 240th ST SW & 12'W c/I of 84th AVE W to install gas service 1 3x5 paving cut anticipated. WAS STREET OVERLAYED WITHIN THE LAST FIVE (5) YEARS? YES NO M Year: 1062i PAVEMENT CUT: ® Yes ❑ No If yes, indicate size of cut: 3 x5 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 72 Hrs + LF X LF SF Parking 72 Hrs ._ --- �........� ...... ..... .. rs + . 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. SIGNATURE Susan SIdick P DATE 3/22/2017 Contractor or Agent NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE CHANNELIZATION DEVICE SPACING MPH 11 TAPER TANGENT 55/70 40 1 80 35/45 1 30 60 25/30 L 26 40 1 w 23914 84th Ave W, Edmonds WA March 16, 2017 Sheet 1 of 2 ryan.honeysett@pse.com (425) 457-5381 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 84th Ave W & 175' NCL of 240th ST SW. 9. If used, place NO -PARK signs 72 hours in advance of the day that the work Is to be done. IhN Jtl � IlW / ffi�IJ°U �C 11 IP 1 I ��M l•-0ZM �p�g �yq� dX h Q Y 0 N 0 1 100' 100' LEGEND n 28' TRAFFIC CONE 9 9 BORE PIT d}iJTin14i WAD TRAFFIC FLOW N N o AHEAD � � FLAGGER ROA ; WORK Q MEAD WORKVEHICLE SIGN LOCATION I I , WARNING FLAG ................. RESIDENT(S) WILL BE INFORMED OF POSSIBLE TEMPORARY DRIVEWAY CLOSURE 23914 23912 CHANNELIZATION DEVICE SPACING MPH N GIvlllJ TANGENT o �I 10M 40 80 a - 30 60 25130 20 at wily avOw D0 0 RESIDENT(S) WILL BE INFORMED OF POSSIBLE TEMPORARY DRIVEWAY CLOSURE 23914 23912 CHANNELIZATION DEVICE SPACING MPH TAPER TANGENT 55f10 40 80 35f45 30 60 25130 20 40 23914 84th Ave W, Edmonds WA March 16, 2017 Sheet 2 of 2 ryan.honeysett@pse.com (425) 457-5381 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 12' WCL of 84th Ave W & 175' NCL of 240th ST SW. 9. If used, place NO -PARK signs 72 hours in advance of the day that the work is to be done. o ti 100' I.-0ZM LEGEND 28' TRAFFIC CONE BORE PIT TRAFFIC FLOW p FLAGGER WORK VEHICLE SIGN LOCATION WARNING FLAG PERMIT REQUEST FORM Date of Request: 03/21/17 Job number: 106321790 Job address: 23914 84th Ave W Project mgr: Andrew Baunsgard PM email: andrew.baunsgard@pse.com Estimated job start date: 04/03/17 Estimated job completion date:. Description of work to be performed: _C ecrviral rri it 04/07/17 City: Edmonds Zil: 98026 PM contact #: (425) 495-4465 Pavement cut? OYes No If yes, Dimensions of Cut: Length 3 Width 5 How many cuts? 1 Surface Type pavement Require trenching? Eyes E]No If yes, Dimensions of trench: Length 3 Width 5 Method of installation: Hole hog Traffic impact: Road closed Dies ✓ No Lane closed Flyes D No How Many? alt Shoulder closed ✓ es El No Sidewalk closed ✓ Yes No Emergency Contact: Andrew Baurtsgar Cell Number: (425) 495-4465 Depth 36 Direction? North Job #: 106321790 Date: 3/6/17 Jurisdiction: Edmonds/ Sno CO. Right of Way Permit? P YES ❑ NO Est. Start Date: Est. Duration: VD-8-KM0_tPT_10W PRE -INSPECTION REPORT * VU61[ I �01 0�'I. I L'IVR'LY Address: 23914 84th Ave W City / Zip: Edmonds 98026 Customer: Rick 425-299-8877 CUS I PROME n UMINER PM / Insp: A.Baunsgard 425-495-4465 PHONE NUMBER Construction Method Open Trench [] Insfohl 48'scat 1-118 stub and 135' Scat 1-118 Extension. Set a 425 meter. Trenchless 0 PLAT MAP LU 23914 23912 4.0 00 135' scat extension 1-1/8" PE I A425 MSA 48' of Scat 171/8" PE ArOAC�Afs,o so k;,a, �.j oF 2, &4 rj (.11, T s#Nt wt " of CL __240.a5T_SW_ &--a- � �IA� f CL:."___84MAye_E_ 'N S of CL__'E W of CE 'N S of CL 'E W of CL FLAGGERS # 2 25 MPH ❑ TROLLY LINES ❑ BUS STOP # ❑ OFFICERS SPEED LIMIT ❑ TRAFFIC SIGNAL ❑ ARTERIAL ❑ -#.. Commercial ❑ Altered Commercial F] Leak Repair Service information ❑ Residential ❑ Altered Residential n CP Work Diameter Meter E] Multi -Family E] Replacement Service n Pothole ❑ 5/8" ❑ 250 E] New Constr. F main Maintenance ❑ Extension Q 11/8" ❑ 425 Stub ❑ Service Maintenance C] 11/4" ❑ 630 ❑ Extension ❑ valve maintenance E] 2" El 1000 ❑ Compete Sery ❑ Cut & Cap Mtr Loc: - of W C4 Cn Uj tL t; 70 Size of Cut I Surface Type ❑ METER HOODS # ❑ NO PARKS # F] Template Bar EFV F] Bollards 2.5" # [] 1800 F] 2600 Bollards 4" # ❑ 10,000 [:] FUEL LINE PERMIT NEEDED Fuel Line Length: Fuel Line Diameter: