ENG20170196-APPROVED PERMIT.pdf(.1TY OF EDMONDS
121 5TH A VENUE NORTH-'EDMONDS, WA 98020
t19 PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20170196
RIGHT OF WAY PERM tT (6-EIJC)
Permit Number: EENG20170196 Expiration Date: 01/03/2018
Job Address: 1040 GLEN ST, EDMONDS Location: 1040 GLEN ST
PSFEInfras ource
P SE/In frasource
C/O Susan att: Sidick
C/O Susan att: Sidick
1660 Park Lane
1660 Park Lane
Burlington, WA98233'
Burlington, WA 98233
(425)457-6353
LICENSE#: infrasl87lc2 EXP: 02/22/2019
worK area is approx 19' N 0/l of Glen M & 2.33' W c/IOI Ulymplc Ave 1 jx�) sort Surlace cut also 12' S c/1 of Glen S
Olympic Ave 12x4 asphalt cut anticipated.
DISRtIPTION INFORMATION
ASSESSED VALUE: $0,00 PROPERTY AREA; 0
SIDEWALK: ( OXO) DURATION IN MONTHS: 0 FEE. $0,00 STREET DISRUPTION TRENCH CUT: (2 X 4 )
PARKING: ('0X0) DURATION IN,MONTHS: 0 FEE: $0.00 YEAR OF OVERLAY: 0 FEE: $0;00
ALLEY ( OXO) DURATION IN MONTHS: 0 FEE: $0,00
INDEMNITY.• The Applicant has signed an application which statesrhe/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 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 THEFINAL
INSPECTION AND ACCEPTANCE O F 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
SPACE PROVIDED,
Printed: Monda , July 031
"Auzal, ?131/7
DATE
❑ FILE COPY [:]' INSPECTOR COPY F-1 APPLICANT COPY
JIN
2017
SUED`
ENG2O17O196
• 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.
• Verify clear bore crossings
• Utility patch restoration to be in accordance with EdmondsStandard detail E2.3
r 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 fiontage 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 0:00am and 6:OOpm 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 of this permit. Issuance of this pen -nit 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: NOTESv
PARTIAL INSPECTION DATE: INITIAL: NOTES;
FINAL INSPECTION APPROVED DATE: INITIAL:
•
MAY 19 20V,BUILDING (
ROW PERMIT NO.: EN+(. 2 , �O`I1 \Q
ISSUE DATE:
GIT -OF -WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: 106324670
CONTRACTOR: PSE/Infrasource
Mailing
Address: 1660 Park Lane, Burlington, WA 98233
•
State License #: INFRASL871C2
City Business License #: NR -023614
CONTACT: Sue Sidick
Phone #: 425-457-6353
Fax #:
Email #: Susan.Sidick@pse.com
—ability
ility Insurance 0 Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 1040 Glen St
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
—commercial_Subdivision City Project ❑' Traffic Control (Only)
❑ Multi -Family N Single Family [] Other
❑ EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit pant of a blanket permit? ❑ Yes ❑* No
ANY AS PERMITS? BLD# �ENG�#
DESCRIPTION OF PROPOSED WORK (Be Specific) : Work area Is approx 19'N C/I of Geln St & 233'W c1l of Olympic Ave
1 3x5 soft surface cut also 12'S c/I of Glen St & 233'W C/I of Olympic Ave 1 2x4 asphalt cut anticipated
WAS STREET OVERLAYED WITHIN THE LAST FIVE (5) YEARS? YES NO ❑ Year:106a
PAVEMENT CUT: ® Yes ❑ No If yes, indicate size of cut: 2 X4
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
m— _- .
Alley 72 Hrs + LF X LF SF
_. Parkin . . 72...
Parking Hrs + LF X LF SF
APPLICANT TO READ AND SIGN
m �.. "rea wumw.w an NrNmmmm�l 009
*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 Si is°SM° °°�°�,.W_s°�"u 5/19/2017
SIGNATURE "" °� DATE
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
PLAT MAP: 162 067
GLEN ST
2" STW IP 19'N
5686-1963
G
G
S- - - - 40 --------------------------- 8
CL _CL
W
G
PL
OVOT
= WATER METER BOX
= SEWER MANHOLE
Q = FIRE HYDRANT (204'E FROM TIE IN)
Sof CL
GLEN ST
PRE -INSPECTION REPORT
Job #:
106324670
12 S f CIL
�.,.
Date:
5/10/17
Address: 1040 GLEN ST
_.
Jurisdiction:
Edmonds
City / Zip: EDMONDS 98020
FLAGGERS #
Right of Way Permit?
Fy] YES ❑ NO
Customer: DENISE O' BRIEN
206-718-3653
Est. Start Date:
07/03/17
PM / Insp: Kiora Hos
WATIM
Est. Duration:
8 Hours
Altered Commercial
PHONE NURSER
Leak Repair
❑✓
Residential ❑
Construction Method
W a�K E�t�rt
CP Work
❑
Open Trench E]
INSTALL 5'OF1-1/B"PESCATSTUBAND 30'OF1-1/B" PE SCATEXT 5ETA250AT6IN
❑
Pothole
❑
New Constr. ❑
Trenchless F1
WC OA
Extension
❑✓
Stub ❑
PLAT MAP: 162 067
GLEN ST
2" STW IP 19'N
5686-1963
G
G
S- - - - 40 --------------------------- 8
CL _CL
W
G
PL
OVOT
= WATER METER BOX
= SEWER MANHOLE
Q = FIRE HYDRANT (204'E FROM TIE IN)
Sof CL
GLEN ST
❑ Template Bar
"
-
12 S f CIL
�.,.
❑ 5/8"
Q 250
—. N S of CIL
_.
Q 11/8"
& 'E to
❑
FLAGGERS #
MPH
❑
TROLLY LINES
❑
OFFICERS #
SPEED LIMIT
❑
TRAFFIC SIGNAL
❑
Commercial ❑
Altered Commercial
❑
Leak Repair
❑✓
Residential ❑
Altered Residential
❑
CP Work
❑
Multi -Family ❑
Replacement Service
❑
Pothole
❑
New Constr. ❑
Main Maintenance
❑
Extension
❑✓
Stub ❑
Service Maintenance
❑/
Extension ❑
Valve Maintenance
❑ Compete Sery ❑ Cut & Cap
SIDEWALK (�
LARGE ROCKERY
0 1
laf.volrAA-116PG4-1%4
0
Size of Cut 1I Surface Type
bf CL..W 3X5 SOFT SURFAct
CL OLYMPIC AVE _ 2X4
ASPHALT
of
CL m..
❑ BUS STOP # ❑ METER HOODS #
❑ ARTERIAL ❑ NO PARKS #
Service information
❑ Template Bar
Diameter
Meter
EFV
❑ Bollards 2.5" #
❑ 5/8"
Q 250
❑
1800 ❑ Bollards 4" #
Q 11/8"
❑ 425❑
2600
❑ 11/4"
❑ 630
❑
10,000 ❑ FUEL LINE PERMIT NEEDED
❑ 2"
❑ 1000
Fuel Line Length:
Mtr Loc:
O1R
Fuel Live Diameter:
ISIV) -
40"t
xto�4
r
tlr,�9u
tuf Ao 1V°d,�Ji �e�
k"
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S5d71P 4e IN,
35445 317 � 60
PUGET
SOUND.
ENERGY
J�eMd1ctA3�2457A,Y
1040 Glen ST, Edmonds WA
May 18, 2017
z ` 7 Sheen oft ryan.honsysell®pse.Lam
(425) 4575381
IVEED AS NOTE
MEND �
-._.m.- ------------ -
Zr'TaARnCCOIE
rel BWtEPrr
TRWM FLOW
ROWCVe1CIE
INCRILOCATxW
WAPNWGF AG
Notes:
1. All signs and sparing to conform to the MUTCD
n
and City of Edmonds standards.
2. All sidewalks, driveways, exits and egresses shall be
completely clear unless otherwise Indicated.
7rr
3.Chennelhingdevices are 28'traffic cones.
4. Sign size can be a minimum of 49” x 49' and shall not
obstruct pedestrian access.
5. Crew Is required to leave a minlmum of 11' for traveling
lane width.
B. Alert affected residents and businesses.
7. Work to lake place between 9 a.m. and 4 p.m.
B. Work area vAfi be 233' WCL of Olympic Ave
819' NCL of Glen ST.
9. If used, place NO -PARK signs 72 hours In advance
,.
of Me day that the work Is to be dam.
IVEED AS NOTE
MEND �
-._.m.- ------------ -
Zr'TaARnCCOIE
rel BWtEPrr
TRWM FLOW
ROWCVe1CIE
INCRILOCATxW
WAPNWGF AG
-i -
r
GLEN ST
a�
_ onnhilmGn 1,77 t y lanes ^-
9011' 41 lfuy 9 too' ...... .,.„.
7
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C.HANNON
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5500 40 a0
ASr45 30 .. 0A
2+`90 70 X40
PUGET
SOUND
ENERGY
Job#106324670
1040 Glen ST, Edmonds WA
May 16, 2017
Sheet 2 of 2 ryan.honeyseit@pse.com
pse.com
(425) 457-5351
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 dear 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 lake place between 9 a.m, and 4 p.m.
8. Work area will be 233' WCL of Olympic Ave
812' SCL of Glen ST.
9, If used, place NO -PARK signs 72 hours In advance
of the day that the work Is to be done.
.....LEGEND
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