ENG20180094-APPROVED PERMIT.pdfE tr,,tt
CITY
121 5TH AVENUE NORTH - EDMONDS, WA 98020
Sri �i PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERM.:rr MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20180094
RIGHT OF WAYPERMIT (6-EUC)
Permit Number: ENG20180094 Expiration Date: 10/01 /2018
Job Address: 23135 75TH PL W, EDMONDS Location: 23135 75TH PL W
PSF/Infrasource
IaSf /kifrasoizce
C/O Susan att: Sidick
(`/O .Susaia aI:s:: Sidick
1660Park Lane
1660 Park Lame
Burlington, WA 98233
Bu lir,f.I.mi, WA 9823:3
(425) 457-635.3
I,K'FNSI34:infraslg7lc2 FXP:02/22/2019
Work area is approx 210' S c/I of 75th Ave W & 2' W -2" E c/I of 75th PL W. 2 3x5 concrete cuts anticipated.
DISRCIPTION 0 ASSF'1 ro61 I) VALUE: $0,00 ICI 0PI ICI'Y AREA. INFORMATION
SFDFI VA.LK: Q Ox0 ) DURA'PION IN M ON"V ➢IS: 0 FFFI: $0,00 STRII Ica' [NSRUI3TION TRENCIII CIJT: ( 3 X 5 )
PARKJNGr Q 0X0) DURATION IN MONTHS- 0 FIE: $0.00 YFAAR OF OVERLAY 0 FI:I.;: $0 00
ALLEY: Q 0%0) F)1JRAA'ION IN MONTIIS: 0 FL : $0.00
INDEMNITY The Applicant has signed an application which states he/she holds the City ofEdmonds harmless from injuries,
damages or claims ofany kind or description whatsoer,er, 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.
THECONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FORA PERIOD OF 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 ofthe 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 DLALrA-DIG (1-800-424-5555) BEFOREANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT.1326
24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQUESTS
THIS A.PPLACAAJON IS NOTA PE, 1'�MITUNrfTI of NELD RY TE3E CTCY H11JGINF,ER OR H ISAIER DEFUlY: AND I LIES Alice PA.II:D, AND RECEIFTIS A.0 KhdC7Wt.,l.i GED IN
SPACE, PROVIDED
RELEASED BY
Printed: Thursday, March 21), 201
U),%k,a 31.7-912ol8
DATE
❑ FILE COPY ❑ INSPECTOR COPY [:] APPLICANT COPY
STATUS: ISSUED
ENG2O18O094
• 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 stamt.
• Conform to 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 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 fi•ontage 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 7:00am to 6:OOpm on weekdays and 10:00am and 6:OOpm 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 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 from the issuance ofthis 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 toenforceany ordinance
provision.
• E-Engineering Final
PARTIAL INSPECTION DATE: INITIAL NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: INITIAL:
611 1 of EVA,10
NJ
E I,'
FI�ECMIVED A k
�'�
MAR of
ROW PERMIT NO.: ENG_C
BUILDING ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: 106336771
CONTRACTOR: PSE/Infrasource
Mailing Address: 1660 Park Lane, Burlington, WA 98233
..... ---------- ---------------------
State License O: INFRASL871C2
. . . . ....... . ...................... . . . . . . . . . ........... . ____ .........................
City Business License #: N R-023614
CONTACT: Sue Sidick
Phone #: 425-457-6353
Fax #:
FmH" #: Susan.Sidick@pse.com
❑.............. . .....
Liability Insurance Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 23135 75th PL W
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
ri-Co'—mmercial 71 Subdivision 0 City Project -1] —Traffic Control (Only)
[_1 Multi -Family 0 Single Family Other
F] E UC (PUD, VERIZON, PSI,,
COMCAST, OVWSD):
Is this permit part of a blanket permit? El Yes [W] No
ANY ASSOCIATED PERMIT:S:?] BLD#ENG# . ... ..... ..
..........
DESCRIPTION OF PROPOSED WORK (Be Specific) : Work area is approx 21 O'S C/1 of 75th AVE W
& 2'W - 2" E c/1 of 75th PL W 2 3x5 concrete cuts anticipated.
WAS STREET OVERLAYED WITHIN THE LAST
------ - - - - — -- — ------ - --- _YE�ARS? YES 0 NO Year: 06b
PAVEMENT CUT: El Yes Fl No If yes, indicate size of cut: _x___
CONCRETE CUT: X Yes F] No If yes, indicate size of cut: 3 — x 5
RIGHT-OF-WAY DURATION
AREA JLF
OTAL
CLOSURE (NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF X SF
.. --.....__ — ...__ ---- —
Alley 72 Hrs + LF X SFParking 72 Hrs + LF X SF
APPLICANT TO READ AND SIGN
RR HIM 00000 �4hil � l�@iNYbmf��G/ u�u�www
*Traffic control and public safety shall be in accordance with City regulations as requircd 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.
t�L tm�Cdu kO Nk Vrw.�.n wwmh �i'M�, w=SIreNUze
SIGNATURE Susan SIdIC � . g s DATE 2/28/2018
ti�xtiw than m�xb�rrar for ��arnr
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Pogel SGund Energy
Traffic Conlrol Supervisor.
erogory Harwood
Carr) No, 008997
Card Exp. 08/131201g
gregory.ha rood@pse.com
(4a5)424-642,6
CHANNELIZATION
DEVICE
SPACING
_MPH TAPER
TANGENT
....: ................
55Rm 4m�
BQ
35/45C7u
�7
is
i,Va�I���r,
1
Notes:
1. All signs and spacing to conform to the MUTCD
and Clty of Edmonds standards.
2. All sidewalks, driveways, exits and egresses
shall be completely clear unless otherwise indicated.
3. Channellzing devices are 28" traffic cones.
Use traffic drums (barrels) with steady burning
Type C lights on all State Routes and Hwys,
4. Sign size can be a minimum of 36" x 36" 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 take place between 9 a,m, and 4 p.m
unless otherwise specified. All work for arterials
and major roadways will be from 9 a.m. to 3 p.m
6. Work area will be 210' SCL of 75th Ave W &
2' WCL to 2' ECL of 751h PI W.
9. If used, place NO -PARK signs 72 hours in
advance of the day that the work is to be done.
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SIGN LOCATION
RIGHT GF WAv
—BBV—aaV-
Puget Sound Energy Gas Pre -Inspect Form
Job #: 106336771
Date: 2/22/18 Address:
23135 75TH PL W
Jurisdiction: EdmondsW�WmW City/ Zip:
Edmonds, 98026
ROW Permit: Yes Customer: JOHN TRANG
206-227-1031
Est. Start Date: IBM 8/18 PM / inspector: 'ordan cooper
425-623-6302
Est. Duration: 1' %7,0
Job Description Scope of Work
From 2 " STW IP 2' W Pavt (68C641-1968) Run NewScat 1 1/4 PE Service 80' (30' Stub 50' Ext)To
New Construction:
Single Family Home and Set A630 OL 40' ROW. SEE ATTACHED CITY OF EDMONDS
UTILITY
tr
MAPS (1 1/4 for future home in back of lot) Please See City Of Edmonds GIS Map
Construction Method
All Scat I Trenchless
FLAT Map; 162067
2 1d°:"'
:y.
\.�
4 y( EXISTING A630MSA
Wolof
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jf
23135 751h PL W
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Work Location
Size of Cut
Surface Type
210'
S
of CL
75th Ave W
&
2' W
of CL
75th PL W
3x5
C
210'
S
of CL
75th Ave W
&
2' E
of CL
175th PL W
3x5
C
Of CL
&
ofCL
Service Information
Street Information
Job Type
Diameter:
1-1/4" PE
Fla, gers 6:
Y
Arterial:
N
I New Residential Svc
EFV:
1 1/4" - 2600 - 9996744
Police q:
N
TCP:
Y
Meter:
Meter
A630
03 OIL
Seed Limit:
1
25
No Parks H:
Mtr Hoods 1i:
Y
N
PucEr
SOUND
ENERGY
6' W.Bus
Traffic Signal:lley
N
Stop:
N
Bollards:
2.5" 0 1 �4" q
ADA Ramps #:
N
Route fl's:
N
�.
6°, Y
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