ENG20190242 Issued ROW Permit.pdfv � OV- Lv
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 ENG20190242
Permit Number: ENG20190242 Expiration Date: 12/06/2019
Job Address: 23803 78TH AVE W, EDMONDS Location: 23803 78th Ave W
PSE/Infras ource P SE/In frasource
C/O Megan Carabba C/O Megan Carabba
1660 Park Lane 1660 Park Lane
Burlington, WA 98233 Burlington, WA 98233
(425)457-6353
LICENSE #: infras1871 c2 EXP: 02/22/2021
JOB DESCRIPTION
Offof 78th Ave W-Installan allSCAT 1-1/8" PE service (46' stub/35' e)d) and then set an A425 O/Rat 23803 78th Ave W. 1 (3x5) hard
and 1 (3x5) soft surface cuts anticipated.
DISRUPTION
ASSESSED VALUE: $0.00 PROPERTY AREA: 0
SIDEWALK: (OXO) DURATION IN MONTHS: 0 FEE: $0.00 STREET DISRUPTION TRENCH CUT: ( 0 X 0 )
PARKING: ( OXO) DURATION IN MONTHS: 0 FEE: $0.00 YEAR OF OVERLAY: 0 FEE: $0.00
ALLEY: { OXO 1 DURATION IN MONTHS: 0 FEE: $0.00
IADEMMTY 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 may be made against the City of Edmonds 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 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 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 pernvt application.
CALL DIALrA-DIG (1-800424-5555) BFFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT.1326
24 HOUR NO TIC E REQ UIRED FOR ALL INSPECTION REQUESTS
THIS APPLICATION IS NOT PERMIT UNTIL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN
SPACE PROVIDED.
Printed: Thursday, June 06, 2019
b /C
DA
❑ FILE COPY ❑ INSPECTOR COPY ❑ APPLICANT COPY
STATUS: ISSUED
ENG20190242
• 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 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 fromtemporary construction sites as a result of construction activity are exempt fromthe noise limits
of ECC 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 fromany and all claims for damages of
whatever nature, arising directly or indirectly fromthe 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.
• &Final Restoration
• E Engineering Final
PARTIAL INSPECTION DATE: INITIAL: NOTES:
PARTIAL INSPECTION DATE. INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: INITIAL:
t Of EC>A,10 ,
� +�4
ROW PERMIT NO.: ENG �( V Z�b 2,
ISSUE DATE:
RECEIVE[
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION MAY 3 0 2019
ENGINEERING DIVISION
PROJECT NAME: 106354831 CONTACT: Megan Carabba
CONTRACTOR: PSE/Infrasource
Mailing Address: 1660 Park Lane, Burlington, WA 98233
State License #: INFRASL871 C2
City Business License #: NR-019840
Phone #: 360-333-9461
Fax #:
Email #: megan.carabba@pse.com
❑ Liability Insurance ❑ Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 23803 78th Ave W
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
Commercial 0 Subdivision City Project El Traffic Control (Only)
❑ Multi -Family ❑X Single Family ❑ Other
❑ EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit? ❑ Yes W No
ANY ASSOCIATED PERMITS? IBLD# ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) : Off of 78th Ave W-Install an all SCAT 1-1/8" PE
service (46' stub/35' ext) and then set an A425 O/R at 23803 78th Ave W.
1 (3x5) hard and 1 (3x5) soft surface cuts anticipated.
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES NO Year:106J
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
AREA
CLOSURE
TOTAL
DURATION
(NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF
Alley 72 Hrs + LF
Parking 72 Hrs + LF
X
LF
SF
X
LF
LF
SF
X
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 understand the permit requirements and acknowledge that I must
follow all requirements in order/for the permit to be valid.
SIGNATURE ,r A // / DATE 5/30/2019
offtractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Puget Sound Energy Gas Pre -Inspect Form
Job #: 106354831
Date:
5/15/19
Address:
Jurisdiction:
Edmonds
City / Zip:
ROW Permit:
Yes
Customer:
Est. Start Date:
7/22/19
PM / Inspector:
Est. Duration:
1 Dav (8 Hours)
23803 78TH AVE W
Edmonds, 98026
SARFRAZ MALIK 206-851-1497
Brian Buschbom (425) 659-0673
Job Description
Scope of Work
Off of 78th Ave W - Install an all scat 1-1/8" PE service (46' stub / 35' ext) and then set an A425 O/R.
New Construction:
0
Construction Method
All Scat / Trenchless
PLAT Map:
167069
238th St SW
ROW 60 Fr
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1-1/8" PE ® A425 MSA
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1
35'
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Work Location
Size of Cut
Surface Type
14'
West
of CL
178th Ave W
&
95'
South
of CL
238th St SW
Tx5'
Soft
12'
East
of CL
178th Ave W
&
95'
South
of CL
1238th St SW
3'x5'
Asphalt/Soft
Of CL
I
&
of CL
Service Information
Street Information
Job Type
Diameter:
1-1/8" PE
Flaggers #:
Arterial:
Residential Conversion SVC
EFV:
1-1/8" - 2600 - 9999144
Police #:
TCP:
Tie -In Fitting
Meter:
A425
Speed Limit:
No Parks #:
Steel - 1" Sery x 1/8" PE Outlet (MOP)
125 3/4" Cutter
Meter Loc:
08 - OR
Trolley Lines:
Mtr Hoods #:
Del Press:
6" W.C.
Traffic Signal:
Bus Stop:
Bollards:
2.5" # 1 4" #
ADA Ramps #:
Route #'s:
UrnITY
woRK
<>
W21 77
NOTIFY EMS, FIRE
100'
-4
AND POLICE
00
72 HOURS IN ADVANCE
_
r
BE
PREPARED
TO STOP
W20-7b
f
238TH ST SW '4 - - — — — — —
r
urnnti
WORK
AHEAD
+
y
100
co
W21-7
�
=
umrry
WORK
AHEAD
D
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m
W21-7
�C
—� -4
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INVENTORY:
6-UTILITY WORK AHEAD
2-ONELANE ROAD AHEAD
3-13E PREPARED TO STOP
4-FLAGGER AHEAD
30-CONES
2-FLAGGERS
'-► 238TH ST SW
ONE LAKE
ROAD
ANEAD
CW20-4 \A-5—N
100
W20-7A
4f
v
00
2
D
m
iIt
I
I
0
I
<* 100
W20-7A
238TH ST SW '4-
1*611I9?
Ww.invarionx
K&D Services, as the preparer of this trai is
unun
control plan makes no representation as to its'
general adequacy or being approved for implementation.
N
Approval must result from the Traffic Engineer or
W21-7
00
other Public Official having statutory enforcement authority
=
in the jurisdiction. Utilization and implementation of this
CA
plan shall be a result of that approval.
4
1 Ref. MUTCD 2009 6A-01 (10)
100
�
FIE
PA RED
TO `-7If'
W20-7b
I�
INSTALL 1 1/8" PE SERVICE (46'STUB/35'EXT.) &SETA425
o RESIDENTS WILL BE INFORMED
w 1 1OF LIMITED DRIVEWAY ACCESS
FLAGGERS ADJUST CONTROLS AS
D I INEEDED FOR OPPOSITE LANE SETUP
M1
�I
I�
CONE
100' W20-7A <9> CW20-4 one lane road ahead
I
I
4 �w
I oKe LAKE � � S�1< e P
ROAo \
AHEAD
CW20-4
I�
w 100'
I�
x
ID
< unLm
M WORK
I � AHEAD
W217
Legend
f f Flagger
® W20-7A Flagger Ahead
W20-7b be prepared to stop
4 W21-7 utility work ahead
® Work Area
Work Truck
PLEASE SCHEDULE
WITH DISPATCH
@ 800.343-4049 OPTA
AND PROVIDE A
COPY OF THE APPROVED
TRAFFIC CONTROL PLAN
NOTIFY
EMS,FIRE
AND POLICE
72 HOURS IN
ADVANCE
Notes:
1. Maintain ped. access to
and through crosswalks
2. Maintain Min. 10' lanes
3. Maintain local access
4. Notify Transit Authority
at least 48 hrs. in advance
of bus stop closure
5. Traffic control plan and all
devices shall comply with
MUTCD, PROWAG & WSDOT
6. DEVICE SPACING
Flag Taper 20'
Signs per WSDOT
Tapers per WSDOT
7. 28" Cones
36" Barrels
48" Signs
24" Paddle
8. Adjust to field conditions
APPROVED AS NOT,
NA, 45-liq
CUSTOMER:
PUGET SOUND ENERGY
CONTACT: MITCH PETERSON
425-398-6071
LOCATION: 2 3 803 78TH AVE W
EDMONDS, WA
(DATE:
W/O #
5-29-19
106354831
Designed By:
E
Garrett Hooper
K & D SE:FtvICES
WSTCS#010855
TRAFFIC MANAGEMENT
Off:600-343-4049 Ext 5860
Cell # 425-551-8297
WATCP(GbKN DSERVICES.N ET