ENG20170264-APPROVED PERMIT.pdfr�,1 Dal
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20170264
RIGHT OF WAY PERM IT (6-EUC)
Permit Number: ENG20170264 Expiration Date: 01 /12/2018
Job Address: 18816 OLYMPIC VIEW DR, EDMONDS Location: 18816 OLYMPIC VIEW DR
�APPLICANT CONTRACTOR
PSF/In fras o urce P SE/In fraso urce
GO Susan att: Sidick C/o Susan att: Sidick
1660Park Lane 1660 Park Lane
Burlington, WA 98233Bwlington, WA 98233
(425)457-6353
LICENSE 4 infras187] c2 EXP:02/22/2019
JOB DESCRIPTION
Work area is approx 12' E c/I of Olympic View Dr & 58' S c/I of Wharf St to install gas service. 1 3x5 paving cut anticipated. "
DISMIPTION INFORMATION
ASSESSED VALUE: $0,00 PROPERTY AREA: 0
SIDEWALK: (OXO) DURATION IN MONTHS: 0 FEE, $0 00' STREET DISRUPTION TRENCH CUT: 13 X 5 )
PARKING:', ( OXO) 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 states he/she holds the City of Edmonds harmless from injuries,
damages or claims ofany kind or description whatsoever, foreseen or unforeseen, that maybe made against the City ofEdmonds;or
any ofils 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 RESPONSIBLEFOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONEVEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK.
• Traffic Control and public safety shall be in accordance with City regulations as required by the City Engineer. Every flagger must
be trained as requiredby(WAC) 296-155-305 and must have certification verifying completion of the required training in their
posseston '
• Restoration is to be inrraccord ance 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 DIALrA-DIG (1-80 0-424-5555) BEFORE ANY EXCAVATION'
CALL FOR INSPECTION (425) 771-0220`EXT. 1326
SPACE P:
�L26G� ZCL
RELEASED BY
LPPROVAL
S/HER DEPUTY: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED, IN
IDED
Printed: Wed 12, 2017
DATE
❑ FILE COPY DINSPECTOR 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 prior to work start.
• Conform to approved working drawings and Traffic Control plan.
• Verify clear bore crossings. Maintain a minimum of 5' horizontal separation from the City utilities and services located within
the City's Right -of -Way. Maintain a minimum of3' horizontal separation and I'vertical separationfrom private water, sewer,
and storm lines located on private property.
•� 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 a result of construction activity are exempt from the noise limits
ofECC 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 fiom the 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,
INSPECTIONS
0' E-Traffic Control
0' E-Engineering Final
PARTIAL INSPECTION DATE: IMTIAL: NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: INITIAL:
•
RECEIVED
jUL 0 J 2017
BUILDING ROW PERMIT NO.: ENG
ISSUE DATE:
RIGIT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: 106325174
CONTRACTOR: PSE/Infrasource
Mailing Address: 1660 Park Lane, Burlington, WA 98233
State License #: INFRASL871 C2
__
CityBusiness License
�cense #: NR-023614
CONTACT: Sue Sidick
Phone #: 425-457-6353
Fax #:
Email #: Susan.Sidick@pse.com
❑ Liability Insurance Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 18816 Olympic View Dr
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
Commercial ❑ Subdivision LJ 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 F No
ANY ASSOCIATED PERMITS? BLD#_ _ ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) : Work area is approx 12' E C/1 of Olympic
view Dr & 58' S c/I of Wharf St to install gas 1 3x5 paving cut anticipated
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES [I NO ❑ Year:106rb
PAVEMENT CUT: ® Yes ❑ No If yes, indicate size of cut:.3 x 5
CONCRETE CUT: ❑ Yes ❑ No If yes, indicate size of cut: x_
RIGHT-OF-WAY 7 DURATION
AREA TOTAL
CLOSURE (NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF X LF SF
Alley 72 Hrs + LF X LF SF
mm.m Parking 72 Hrs mmm^ LF X LF SF
APPLICANT TO READ AND SIGN
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*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.
ftn y u� Ms SWs
Susan Sidick �m� k.a�°�°°� 7/5/2017
SIGNATURE " "'"" � °vo " 9 DATE
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 008997
Card Exp. 08/13/2019
gregory.harwood@pse.com
(45)424.6425
0
k25/3O
NNELIZATION
ICE SPACING
TAPER TANGENT
40 80
30 60
20 40
@
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t�4pptttl � Fkr r��ot" �uf jr'pr ry n, �,lt� 4'� t i` y
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3.
4.
Notes:
All signs and spacing to conform to the MUTCD
nd City of Edmonds standards.
. All sidewalks, driveways, exits and egresses shall be
ompletely clear unless otherwise indicated.
Channelizing devices are 28" traffic cones.
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
ane width.
i. Alert affected residents and businesses.
Work to take place between 9 a.m. and 4 p.m.
1. Work area will be 12' ECL of Olympic View Dr & 58' SCL
)f Wharf St.
!. If used, place NO -PARK signs 72 hours in advance
)f the day that the work is to be done.
Q
f
Tk C 1 S Nb-r t t
ENGINEERING
LEGEND
28" TRAFFIC CONE
BORE PIT
TRAFFIC FLOW
FLAGGER
WORK VEHICLE
SIGN LOCATION
WARNING FLAG
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 008997
Card Exp. 08/13/2019
gregory.harwood@pse.com
(425)424.642P
A
18816
CHANNELIZATION
DEVICE SPACING
MPH TAPER TANGENT
55/70 40 80
35145 30 60
25/30 20 40
r Z",
PUGET
SOUND
ENERGY
Job#106325174
18816 OLYMPIC VIEW DR, EDMONDS, WA
l / Date, 2017
Sheet 2 of 2 yuriy.bashtovoy@pse.com
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INotes:
i 1. All signs and spacing to conform to the MUTCD
and City of Edmonds standards.
i 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
N 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 between 9 a.m. and 4 p.m.
8. Work area will be 12' WCL of Olympic View Dr & 58' SCL
of Wharf St.
9. If used, place NO -PARK signs 72 hours in advance
of the day that the work is to be done.
0
04
Z
LEGEND
28" TRAFFIC CONE
BORE PIT
TRAFFIC FLOW
FLAGGER
WORK VEHICLE
N SIGN LOCATION
WARNING FLAG
Puget Sound Energy Gas Pre -Inspect Form
Job #: 106325174
Date: 6/9/17 Address: 18816 OLYMPIC VIEW DR
Jurisdiction: Edmonds City / Zip: EDMONDS, 98020
ROW Permit: Yes Customer: ROBERT B SWERK 425-508-7721
Est. Start Dater 8/14/17 PM / Inspector: Kevin Williams (425) 691-7573
Est. Duration: 2 Days'
Job Description 7 Scope of Work
From 4" PE IP Main run new 1-1/8 PE service to new residential home (36' stub with 147' EXT. New Construction:
ALL scat) Set A-630 OR @ Inches ------ es
Construction Method
All Scat I Trenchless
PLAT Map: 161.067 9QIPN WHARF t
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Work Location Size of Cut Surface Type
12' E of CL Olympic View DR & 58' S of CL lWharf ST 3x5 Asphalt
Of CL I of CL
Of CL & Of CL
Service Information Street Information Job Type
Diameter: 1-1/8" PE Flaggers#: Arterial:
EFV: 1-1/8" - 2600 - 9996743 Police #: TCP: Yes
Meter: A630 Speed Limit: No Parks #: PUGET
Meter Loc: Trolley Lines: Mtr Hoods M souNn
ENERGY
Del Press: 6" Vt X. Traffic Signal: I Bus Stop:
Bollards: 2.5" # 4" # ADA Ramps #: Route #'s: