ENG20170104-APPROVED PERMIT.pdf1 tv
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
OF
t PHONE: (425) 771-0220 -'FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED
ENG201701
Permit Number: ENG20170104 Expiration Date: l l /27/2017
Job Address: 8711 218TH ST SW, EDMONDS Location: 8711 218TH ST SW
APPLICANT CONTRACTOR
PSE/Infras ource P SE/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 #: infrasl871 c2 EXP:02/22/2019
1 F JOB DESCRIPTION
Work area is approx 13's &2'& 15' N c/I of218th ST SW &34' E c/I of 87th',PL W to install gas service 13x5 asphalt, 1 2x7 asphalt /soft
surface, &'I 2x4 private property cuts anticipated.
!ASSESSED VALUE:$0,00 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: $0,00
INDEMNITY The Applicant has signed an application fvhich states he/she holds the City of Edmonds harmless from injuries,
damages or claims ofany'kind or description vvhalsoever, foreseen or unforeseen, that may be made against the City'ofEdmonds 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.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONEYEAR FOLLOWING THE FINAL
INSPECTION AND'ACCEPTANCE OF THE W 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 REQUESTS'
APPROVALAPPLICATION �
THIS APPLICATION IS NOT A PERMITUNTIL SIGNED BY THE CITY ENGINEER OR AIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPTIS ACKNOWLEDGED IN
SPACE PROVIDED;,,
Printed`: Friday, May 26, 2017
RELEASED BY DATE
E] FILE COPY ❑ INSPECTOR COPY ❑ 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 priorto 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.
• Call for required inspections as noted`
• Traffic Control per approved plan and MUTCD. Refer to City of Edmondstraffic control requirements.
a 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 7:00am to 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 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 pen-nit. 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.
INSPECTIOMS
• E-Engineering Final
PARTIAL INSPECTION' DATE: INITIAL: NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: INITIAL:
7 2017
ROW PERMIT NO.: ENG �-7 '010q
BUILt)INGISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT ,IT APPLICATION
PROJECT NAME: 106319531
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: 8711 218 ST SW
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
....
Commercial Subdivision City Project Traffic Control (Only)
❑ Multi -Family 0 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 13's & 2'& 15'N C/1 of 218/th
ST SW & 54'E c/I of 87th PL W to install gas service 1 3x5 asphalt, 1 2x7 Asphalt / soft surface, & 1 2x4
private property cuts anticipated,
WAS STREET OVERLAYED WITHIN THE LAST FIVE (5) YEARS? YES NO Year: 106&
PAVEMENT CUT: ® Yes ❑ No If yes, indicate size of cut: 3 x 5
CONCRETE CUT: 0 Yes ❑ No If yes, indicate size of cut: x_
Fey
OF-WAY DURATION
SURE AREA TOTAL (NUMBER OF MONTHS)
alk 48 Hrs + LF X LF SF
l72 Hrs + 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.
Susan Sidick°
gar,�r �ItNtti G3.44NG7 d>.7d ��?rSnY
SIGNATURE ° 0,010 " �"" ` �'"
DATE 03/27/2017
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
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 canes.
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 end businesses,
7. Work to take place 'betweera 7a.m. and 6P.M.
8. Work area will be 54' ECL of 87th PI W & 13' SCL 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.
i Co
00
18 18 '� 8711
b�4 �
218th St S W
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L Zo•i
�
101101
a ®....
a•
41
4 ¢ LEGEND
W201 W20 -7A o�p! 28' TRAFFIC CONE
W0 f= BORE PIT
TRAFFIC FLOW
i T' FLAGGER
CP' BAN E �El 1264 P tCYN WORK VEHICLE
DEVICESPACING
PAP>Pt I TAPER ITANGENT` � SIGN LOCATION
:s,JJ�O. p`�
35/45 30 60 l� WARNING FLAG
25/30 20 40 m
L j 00
18 ' 18
b�4 �
ZA
CHANNELIZATION
DEVICE SPACING
TA1Er# Y fANGr`NT'
253 30 0
0 w ZD u.....S
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 betweenly a.m. and .m.
8. Work area will be 54' ECL of 87th PI W & 2'& 13' 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.
218th St SW
i oo.
A
M
8711
a 10
I4
b-0ZM
A .' \ L-0ZM
LEGEND
28' TRAFFIC CONEmX
„, BORE PIT
TRAFFIC FLOW
FLAGGER
WORK VEHICLE
SIGN LOCATION
�a WARNING HAG
JOB #: 106319531 PRE -INSPECTION REPORT P('16t I M)UIVO HVI V
DATE: 3/14/17 ADDRESS: 8711 218th St Sw
JURISDICTION: Edmonds monds CITY/zIP: Edmonds 98026
ROW PERMIT: ❑ YES ❑ NO CUSTOMER: Select Homes (Contact Gary) 206-730-0670
`hl MYitSi i 9'YY...
START DATE: PM' Jordan McLean 425-563-3703
DURATION: 1 day
WOR.] 1II?5 111 r10M j INSTALL METHOD
'I"renchless ID
From main, install approx. 72' of 1-1/8" PE scat/plat svc., and set an A425 mOpen Trench Eleter. Customer provided conduit. New Construct El
Existing]
..............
PLAT MAP: 164. 068....,, ... ..,..... ..., t/t,., 1
i 8711 ,
CALA, V09-
A425 NOTE:
it+1SA
Stub: 30'
" Ext: 42'
- l I-VNlr4%)v4 OF Power, CN, Fiber,
i a t all OH.
�t 1
No Curb/gutter
tt9 Q °1 011 .11
P�t No sidwalk
y R ROW = 50' Wide
PAV%11 6'0 i °T *Hy
B I = 18' Wide
e 1-1/8" PE p *Hydrant H13 -7B is
ll 1 F q • ,. � 146ft East of tie-in*
CTRM 19" Pyr
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li'« til
4
««.es.nx. ... ... ..... .r. .:.+n. ............................... I ........ ... ....w .....«... ,,, o-.. n. .,...ror... ,., f......, ................ . ........»...... �AI"YBYJ`.4.R....5�117wn...«....
«,-»---.»-.----- ------ 2 PE IP 1359800915 -----
c•-
WORK LOCATION
Size of Cut
Surface Type
—13
S 'A CL ------ 218th_S_T5_W_._._
& 4 &v of CL
87th PL W
3x5
Asphalt
Sof CL
_.....,Mt11_b _W
...
&�4— 'E W of CL
.
$.7.th_FL W
2x7
Asphalt/Soft
of CL
218th ST SW
&._.5A_ 'E W of CL
87th PL W
2x4
Private Prop.
❑
FLAGGERS #
MPH
❑
TROLLY LINES
❑
BUS STOP #
❑
METER HOODS #
❑
OFFICERS #
SPEED LIMIT
❑
TRAFFIC SIGNAL
❑
ARTERIAL
❑
NO PARKS #
commercial
❑
Altered Commercial
E]Leak
Repair e Information
E]
Template Bar
Residential I
❑
Altered Residential
F1
Diametersvi
CP WorkMeter
EFV
Pressure ❑
Bollards 2.5" #
Multi -Family
❑
Replacement Service
❑
Pothole ❑ 5/8"
❑
250 ❑ 1800
6" WC ❑
Bollards 4" #
F2]E]E]❑'
Constr.
Maintenance
Extension 1-1/8"
425 ❑Q 2600
❑
2#
❑
Stub
F1
Service n
❑ 1-1/4"
630 ❑ 10,000
❑
>5q ❑ FUEL
LINE PERMIT NEEDED
❑
Extension
❑
Valve Maintenance
EI 2"
1000 ❑ 775
Fuel Line Length:
❑Compete
p Sery
❑
Cut & Ca P Meter l.c�c^:
OR 08
D3000
Fuel Line
Diameter:
8,711 218TH ST SW EDMONDS ,98026
ail"
0