ENG20170182.pdfJY CJS
CITYOF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
r� e 18x1 PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20170182
RIGHT OF WAY PERM IT (5 -City Project)
Permit Number: ENG20170182 Expiration Date: 07/10/2017
Job Address: 121 5TH AVE N, EDMONDS Location: Intersection 6th Ave S & Elm Way
APPLICANT CONTRACTOR
Puget Sound Energy / Infrasource Puget Sound Energy / Infrasource
GO Gregory Harwood C/O Gregory Harwood
1600 Park Lane 1600 Park Lane
Burlington, WA 98233 Burlington, WA 98233
(425)424-6425
LICENSE #: EXP:
Move a section of gas main by request of City
ASSESSED VALUE: $0.00 PROPERTY AREA: 0
SIDEWALK: (OXO) DURATION IN MONTHS: 0 FEE: $0.00 STREET DISRUPTION TRENCH CUT: (OXO)
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
INDEMATTY The Applicant has signed an application which stales 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 costs and
attorney fees by reason ofgranling this permit.
THE C O NTRAC TO R IS RESPO NS IBLE FO R WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
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
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.
THIS APPLICATION IS NOTA
CALL DLALrA-DIG (1-800-424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT. 1326
24 HOUR NO TIC EREQ UIRED FOR ALL INSPECTION RWUESTS
SIGNED BY THE CITY ENGINEER OR HISMERDEPUTY: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN
SPACE PROVIDED,.
4Sm BY DA -r'
❑ FILE COPY ❑ INSPECTOR COPY
Wednesday, May 10, 201
APPLICANT COPY
STATUS: ISSUED
ENG20170182
• 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.
• Public utilities maintain 5' separation from City Utilities.
• 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 aresult 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 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 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.
• &Traffic Control
• 1rEngineering Final
PARTIAL INSPECTION DATE: INITIAL: NOTES:
PARTIAL INSPECTION DATE: INITIAL:NOTES:
.......................................
FINAL INSPECTION APPROVED DATE: INITIAL: