ENG20170215-APPROVED PERMIT.pdf1
CITY OF EDMONDS
121 5TH AVENUE NORTH-EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOB'SITE*
STATUS: TISSUED ENG2
RIGHT OF WAY PERMIT (6-E(,JQ
Permit Number: EN G20170215
Job Address: 655 MAIN ST # 1 O1, EDMONDS
APPLICANT CONTRACTOR
CablecomLLC Cablecom LLC''
1316 Bonneville Ave CIO STEVEN NIELSEN
Bldg. A 1316 Bonneville Ave
Snohomish, WA98290 Bldg A,
Snohomish, WA 98290
(360)454-3163
LICENSE# CABLEL*971DP E
Location: 655 MAIN' ST
French approx 1 iS placing 1, 4" ;conault. proot ana;pun nner from existing pole to new pole moving riser ana existing system from
eiusting pole to new pole.
I)ISR[JPTION INFORMATION
A 'SESSET) VALUE; $0,00 PROPERTY AREA: 0
SIDEWALK: (OXO) DURATION IN MONTHS: 0 FEE. $0,00 STREET DISRUPTION TRENCH CUT: (5'X 10 )
PARKING. ` ( OXO) DURATION IN; MONTHS: 0 FEE: $0,00 YEAR OF OVERLAY 0 ` FEE: $0„00
ALLEY (,OXO DURATION IN MONTHS: 0 FEE WOO”
INDEMNITY The Applicant has signed an application which states he/she holds 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 ils departments or employees, including but not limited to the defense of any legal proceedings including defense costs and
attorney fees by reason ofgranting this permit.
THECONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD O'F 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
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.
r 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 FORALL,INSPECTION REQUEST'S
SPACE PROVIDED„
Printed ,�Monda - ,l�uI J0 ,201°
C'! 713120/7
RELEASED BY DATE
FILE COPY INSPECTOR COPY APPLICANT COPY
ENG20170215
• 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 restorationto be in accordance with Edmonds Standard detail E2.3
Maintain erosion & sedimentation control. Keep street clean.
• Call for required inspections as noted.
0 Traffic Control per approved plan and MUTCD. Refer to City of Edmonds traffic control requirements.
0 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 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 ofhis 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 fromthe 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.
• E -Engineering Final
PARTIAL' INSPECTION' DATE: -INITIAL:-- INITIAL: NOTES NOTES:
PARTIAL INSPECTION DATE:
FINAL INSPECTION APPROVED DATE: INITIAL:
W, OF EOA4,-,.
'A/c, I SqQ
SCANNED
Ili P� 0 12017
JUN 0 1 2017 ROW PERMIT NO.: ENG a00 -())L
DEVELOPMENT SERVICES ISSUE DATE:
.IG:HT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: HELLERAN SP - JOB# 236034
CONTRACTOR: Cablecom LLC
Mailing Address: 1316 Bonneville Ave. Bldg A
Snohomish, Wa 98290
State License #: CABLEL*971 DP
City Business License #: NR -021818
CONTACT' Comcast - Cody Shackett
Cablecom LLC - SUNSHINE CRABBS
Phone #: 360) 454-3163
Fax #: 360-836-3174
Email #:
Omcast - waconstru ionJointuse cal e.comc29t,com
Cablecom LLC - un Mina crabb (ftablecoinllc.net
- Liability Insurance Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 111
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
.....
Commercial El' subdivision City Project ❑ Traffic Control (Only)
❑ Multi -Family ❑ Single Family ❑ Other
Sf EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit? ❑ Yes N No
ANY ASSOCIATED PERMITS? B�D# w wwwwmmm„ ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) : TRFNrH APPRnx 18', PI CI f, 1 A"
r,rwini IIT PR AAll1 I II I DIRER R (1M FXIRT D(ll G T!1 AIF\A/ DnI F R Mll DICCD AAlfl
5X 11N
.0 . �E ..FPQhA EXIRTIN�. P�QI F Tn �p .l F �_� .......�
ITHIN THEmLAST FIVE (5) YEARS? YES NO ❑ Year.
PAVEMENT CUT: ❑ Yes N No If yes, indicate size of cut: x
CONCRETE CUT: N Yes F-1No If yes, indicate size of cut: 5 10
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 Q22f, , DATE 6/01/2017
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
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