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ENG20170130-APPROVED PERMIT.pdfcI t r CITY OF EDMONDS 121 5TH AVENUE NORTH - EDMONDS, WA 98020 lnc l g�� PHONE: (425) 771-0220 - FAX: (425) 771-0221 *PERMIT MUST BE POSTED ON JOBSI"T" * STATUS: ISSUED ENG20170130 Permit Number: ENG20170130 Job Address: 9821 228TH PL SW, EDMONDS PSE/Infrasource C/O Susan att: Sidick 1660 Park Lane Burlington, WA 98233 Work area is approx 16'S c/I of 228th PL SW & 17 W c/I of! ExpirationDate: 11 /09/2017 Location: 9821 228th PL SW P SE/I nfraso urc e C/O Susan att: Sidick 1660 Park Lane Bwlington, WA 98233 (425)457-6353 LICENSE 4: infras1871c2 _ EXP: 02/22/2019 Ave W to install gas service. 1 2x5 paving cut anticipated, !ASSESSED VALUE: $0,00PROPERTY AREA- 0 SIDEWALK: (OXO) DURATION IN MONTHS: 0 FEE. $0,00 STREET DISRUPTION TRENCH CUT: (2'X 5 ) PARKING: ( OXO) DURATION IN MONTHS: 0 FEE $0;00 YEAR OF OVERLAY: 0 FEE: $0 00 ALLEY: ( OX0) DURATION IN MONTHS: 0 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 ofanykind 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 lhispermil. THECONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OFONEYEAR FOLLOWING THEFINAL INSPECTION AND ACCEPTANCE OFTHEWORK. 0 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. 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 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 ANYEXCAVATION CALL FOR INSPECTION (425) 771-0220 EXT. 1326 24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQUESTS APPLICATION APPROVAL THIS APPLICATION IS NOTA PERMITUNTIL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN SPACE PROVIDED,. Printed: Tuesday, Mav 09, 2017 5/8/_7_ 1 F ❑ FILE COPY r_� INSPECTOR COPY ❑ APPLICANT COPY ST • 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. • Conformto 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 requiredinspections as noted. i Traffic Control per approved plan and MUTCD. Refer to City of Edmonds traffic control requirements. Applicant shall repair/replace all damage to utilities or fiontage improvements in City right-of-way per City standards that is caused by or occurs during the pennitted 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:OOpm 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 hamiless the City ,ofEdmonds, 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 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. • E -Engineering Final PARTIAL INSPECTION DATE: _ INITIAL: NOTES: PARTIAL INSPECTION DATE: IMTIAL: NOTES: FINAL INSPECTION APPROVED DATE: INITIAL: 4c 189 OF SCANNED APR 19 2011 APR 2 0 201"1 BUILDING ROW PERMIT NO.: ENG C�X I-2' 013 0 ISSUE DATE: RIGHT-OF-WAY CONSTRUCTION PERMIT APPLICATION PROJECT NAME: 106323082 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: 9821 228th PL SW ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT: Commercial Subdivision 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 © No ANY ASSOCIATED PERMITS? . _.. ENG DESCRIPTION OF PROPOSED WORIK (Be Specific) : Work area is approx 16' S C/1 of 228th PL SW & 5ewU tc e. 17'W c/1 of 98th AVE W to install gas -taiga. 1 2x5 paving cut anticipated, WAS STREET OVERLAYED WITHIN THE LAST FIVE (5) YEARS? YES NO Year:106� PAVEMENT CUT: ® Yes ❑ No If yes, indicate size of cut: 2 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 ..... .......... _r— ............ __._._._..... Alley 72 Hrs + LF X LF SF .� .....Parkm 72....: g _.� _____ ..................._ Hrs + LF X LF SF APPLICANT TO READ AND SIGN �94"1f1f�lY d01P@W@W�&1010 muu�m �.99M�100 �Mn *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 04/18/2017 SIGNATURE Contractor or Agent NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE C'04 o� O ,. 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E YES ❑ NO Customer: Travis 360-420-3699 Est. Start Date: PM I Insp: A.Baunsgard 425-495-4465 ......... Est. Duration: PHONE NUMBER V_QRK N,, Construction Method Install 46 'sca t 1-118 stub and 100' Scat 1-118 Extension. Set a 425 meter. Main is inserted. Open Trench ❑ CM has approved service route. Trenchless A425 MSA 1137 N.W14A ME M WE] 1-1/8 PE 46' scat stub 100' scat extension SID, PEI I P36 M SIWRAPEI Utz -W. 2�wp_e ?: Qi 9805 00 piX, ,o y, L-ex-mr-tw.) 228TRP, SW 114" PE IP 165 4 518" PEIMIFT] 'PES 011-9.4 W_ �AIJPJIA) -VA-JF, P/CoH7 Of-, I'Ayb'f tv7Ar4AJ1N1rs) A t11AJ0Wt4. Op �' )JO17#70AS14t 1' 0 Apt) 11 loos Bilm 9726 9718 2C"S �numamme 5/U'AAPE1 20OP-E Size ofCut I Surface Type 0 __2281th.P_L.9W_._ &--JL- - W f CL _..9.ftttAvp_W_ 2x5 Asphyalt N S of CIL _'N 'E W of CL 9"of CL 'E W of FLAGGERS # 1 26 MPH ❑ TROLLY LINES ❑ BUS STOP # F1 METER HOODS # F1 OFFICERS # SPEED LIMIT ❑ TRAFFIC SIGNAL ❑ ARTERIAL ❑ NO PARKS # ❑Commercial F] Altered commercial Leak Repair Service Information El Template Bar ❑ Residential E] Altered Residential ❑ CP Work Diameter Meter EFV E]❑ Bollards 2.5" # Multi -Family E] Replacement Service E] Pothole ❑ 518" ❑ 250 ❑ 1800 ❑ New Constr. ❑ Main Maintenance ❑ Extension 11/8" ❑ 425 2600 E] Bollards 4" # M Stub Service Maintenance El 1114' ❑ 630 E] 10,000 E] FUEL LINE PERMIT NEEDED Extension E] valve maintenance E] 2" El 1000 Fuel Line Length: Compete Serv, E] Cut & Cap Mtr Lac: Fuel Line Diameter: