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ENG20180253-APPROVED PERMIT.pdfJATY Ot' 4 EDMONDS 121 5TH AVENUE NORTH - EDMONDS, WA 98020 PHONE: (425) 771-0220 - FAX: (425) 771-0221 *PERMIT MUST BE POSTED ON JOBSITE* STATUS: ISSUED ENG20180253 Permit Number: ENG20180253 Expiration Date: 02/18/2019 Job Address: 9227 OLYMPIC VIEW DR, EDMONDS Location: 9227 OLYMPIC VIEW DR OR SNOHOMISH COUNTY PUD SNOIJOMISH COUNTY PUD P.O. BOX 1107 P.O BOX 1 107 EVERETT, WA 98206 EVERET" [', WA. 99206 (425) 670 -32 16 LICENSE `I: EEXP: t DESCRIPTION Close the west bound lane to modify the e)asting AT&T site along Olympic View Drive. ASSESSED VALUE,: SIDEWALK: (OXO ) PARKING: ( OXO ) ALLEY: t OXO I $0.00 PROPERTY AREA: 0 DURATION IN MONTHS: 0 TEE : $0.00 , l'FdEET DISRUP"I'ION TRENCH CUT: ( 0 X 0 ) DURATION IN MONTIiS: 0 FEE: $0,00 YEAR OF OVERLAY: 0 HEIE: $0,00 DURATION IN MONTIM 0 FEE; $0 00 IADEMATTY The Applicant has signed an application which states he/she holds the City ofEdmonds harmless from injuries, damages or claims ofany kind or description ivhatsoever, 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 ofgranling this permit. THE CONTRACTOR IS RESPONSIBLEFOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONEYEAR FOLLOWING THEFINAL INSPECTION AND ACCEPTANCE 0 FTHEWORK. • 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 DIALrA-DIG (l-800-424-5555) BEFORE ANY EXCAVATION CALL FOR INSPECTION (425) 771-0220 EXT.1326 24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQUESTS "rTUS APPLIC.A.TION IS N01 A. PE.RMITUN11L ,SIGNED BY THE C IV ENGrNEER ORHIS(HER DEPUTY: AND FEES ARE PAID, AND RE CEIPTIS ACkNOWLEDGED IN SPACE PROVIDED, RELEASED BY Printed: Thursd ay. Aueust 16. 201 DATE ❑ FILE COPY INSPECTOR COPY APPLICANT COPY STATUS: ISSUED ENG20180253 • Restore ROW to City standards • Restore Landscape to like or better conditions. • Call for locates of underground utilities prior to any excavation. • Alert affected res idents 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 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 fiontage improvements in City right-of-way per City standards that is caused by or occurs during the permitted project. • Sound/Noise originating fromtemporary construction sites as a result of construction activity are exempt from the noise limits ofECC Chapter 5.30 only during the hours of 7:00am to 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. INSPECTIONS • E-Engineering Final PARTIAL INSPECTION DATE: wwwww_ INITIAL: m NOTES:_ PARTIAL INSPECTION DATE: a INITIAL. ......... NOTES: FINAL INSPECTION APPROVED DATE: INITIAL: of EDA1 O ROW PERMIT NO.: ENG 20 ISSUE DATE: RIGHT—OF—WAY CONSTRUCTION PERMIT APPLICATION PROJECT NAME: 10 06 Mo d i F CONTACT: d 1-1 C' .... -- ....... _ CONTRACTOR: Phone #: Li 5 Mailing AdcL ess , o Fa x #: ... ........ State License #: Email #: City BusinessW�� License #: __..�����. ..... ....._. Liability Lisurance Bonded ADDRESS OR INTERSECTION OIL' CONSTRUCTION: ! e, ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT: Commercial ❑ Subdivision City Project 4Nt Traffic Control (Only) ❑ Multi -Family ❑ Single Family EUC (PUD, VERIZON, PSE, COMCAST, OVWSD): Is this permit part of a blanket permit? ❑ Other ,[0 Yes ❑ No ANY ASSOCIATED PERMITS? BLD# ENG# _ mITITIT� DESCRIPTION OF PROPOSED WORK (Be Specific) : �� £ A _ M✓ U r r ...._.�_........... WAS STREET OVERLAYED WI THIN THE LAST FIVE 5 YEARS? YESF❑ NO Year: PAVEMENT CUT: ❑ Yes El No If yes, indicate size of cut: X. CONCRETE CUT: ❑ Yes 0 No If yes, indicate size of cut: X. RIGHT-OF-WAY AREA Pq DURATION CLOSURE (NUMBER OF MONTHS) Sidewalk 48 Hrs + LF X L Alley 72 Hrs + LF X LF SF ... Parr_... ......�.. m,...,.... n g 72 Hrs + LF F X LF SF 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 ulldq.;s(ai d the permit requirements and acknowledge that I Hurst 11 follow all requirements in order. of l l cry lc..bc valid. SIGNATURE DATE - (n b( l Contractor, or Agent NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Sa W _ 11 � 11, :u m h� Y � I z w G c� uo fx lk TI r `sM eP f ,Y WJ � nJ�N r +ter a k '�y "rt 7 L rX, `'kid 4 mamwu m'm'm'� t rw,ea 2mn q�rati.Wcw `� w alabns10 Y 1'C�PPU 4Y{JH fGN"".I'idA99K � '� e _ M rbaap^n�„��,loeur• "�,o� �% 5 9 'y'Iry YI'RIG2A, 1 I�%yy.W8�kf 4d1,d.1�4A8%IX . .u^h P",dY d CONSTRUCTION OPERATIONS AND ENGINEERING REQUEST 1818 Rev.11/98 TO FROM GATE KEITH ELLISON AZ1Z HAQ 425-783-5251 16/11/2018 ADDRESS/LOCATION/POLE NUMBER 9227 OLYMPIC VIEW DR., EDMONDS // 13(27-3)NE // PLI: 263462 MAP NO. WORK ORDER NO. TASK NO. 454-H2 100031391 30 ACTION• • PLEASE ASSIST AT&T WITH THE MODIFICATION OF THEIR CELL SITE MODIFICATION INCLUDES REPLACING ANTENNAS AND OTHER POLE MOUNTED EQUIPMENT POLE HEIGHT: 53' AGL 1COORDINATE WITH KYLE MOERGELI- 425-305-9105 ire 1r 4(, COA). L006 .w "At, 8F 1L4161. IMPMP404511 101 -107432-Y / v4 10 © 9104 0 007 A3`609 FU40 197599 A3661 4 fU6 9.110 M9110 �2 25356125 m..,... ww.. 1 342f11" 126 2. ", SL-130672-A . E-06095 1 66 9.0 � 17G37 � 1� 910 10 21 4� 346 SL-1143'33. For de -energizing customer service for Customer work CUSTOMER CREW HOURS When completed, Coll the PUD at 425-783-1000 rrGer Signature Dote or (1-877-783-1000) ask Custo g for Energy Control Dispatch �iION' OR OTHER ACTION- EOU IR ED A PROV�D COMPLETED BY DATE ,- 2 m I 015tr&uli'on: lle-Doppo0ment Resp nslble For Work -Return To Orkinolor When Completed Blue-GIS, 03, After Work Complel'wn cwnory-1lepartment ResponsVe For Work;4h Copy Palk-aig'notor