Issued ROW Permit ENG20190259.pdfor E D,1l
� CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: 425 771-0220 - FAX: 425 771-0221
42e. la�o ( ( )
*PERMIT MUST BE POSTED ON JOBSiTF_.*
STATUS: ISSUED ENG20190259
RIGHT OF WAY PERMIT (6-EUC)
Permit Number: ENG20190259 Expiration Date: 12/18/2019
Job Address: 7212 220TH ST SW, EDMONDS Location: 7212 220th St SW
PSE/Infras ource
P SE/In frasource
GO 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
Perform yearly inspection for TS-034202 attest lead wire box located at 26' S of GL of 220th St SW and 57E of C/L of Hwy 99. No cuts
anticipated. Job #887033545
10SIZU'TION INFORMATION
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) 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 may be made against the City of Edmonds or
any of its 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 RESPONSIBLEFOR WORKMANSHIP AND MATERIALS FOR A PERIOD OFONEYEAR 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.
• Three sets of construction drawings of proposed work are required with the permit application.
CALL DIAL -A-DIG (1-800424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT.1326
24 HOUR NO TICE REQ UIRED FOR ALL INSPECTION REQUESTS
THIS APPLICATION IS NOTA PER IITUNTIL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN
SPACE PROVIDED.
RELEASED
DA
Printed: Tuesday. June 1
❑ FILE COPY ❑ INSPECTOR COPY ❑ APPLICANT COPY
STATUS: ISSUED
ENG2019O259
• 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 Controlper 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 from any 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.
• E-Traffic Control
• &Engineering Final
PARTIAL INSPECTION
PARTIAL INSPECTION
FINAL INSPECTION APPROVED
DATE:
DATE -.-
]DATE:
INITIAL: NOTES:
INITIAL: NOTES:
INITIAL:
C�/0 of EVAIold
ROW PERMIT NO.: ENG -7,0 tj I
- ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION RECEIVED
PERM IT APPLICATION
JUN 05 2019
PROJECT NAME: 887033545
CONTRACTOR: PSE/Infrasource
Mailing Address: 1660 Park Lane, Burlington, WA 98233
State License #: INFRASL871 C2
City Business License #: NR-019840
CONTACT: Megan Carabbf NGINEERING DIVISION
Phone #: 360-333-9461
Fax #:
Email M megan.carabba@pse.com
❑ Liability Insurance ❑ Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 7212 220th St SW
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
❑ Commercial ❑ 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 n No
ANY ASSOCIATED PERMITS? BLD# ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) : Perform yearly inspection for TS-034202 at
test lead wire box located at 26' S of C/L of 220th St SW and 5T E of C/L of HWY 99. No cuts anticipated
Job #887033545
WAS STREET OVERLAYED WITHIN THE LAST FIVE (5) YEARS? YES ❑ NO ❑ Year: 887&
PAVEMENT CUT: ® Yes ❑ No If yes, indicate size of cut:
CONCRETE CUT: ❑ Yes ❑ No If yes, indicate size of cut:
x
x
RIGHT-OF-WAY
CLOSURE AREA
TOTAL
DURATION
(NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF
Alley 72 Hrs + LF
Parking 72 Hrs + LF
X
X
X
LF
LF
LF
SF
SF
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 " DATE 6/5/20 1 9
i�or or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
PROJECT LOCAI F_D A(-
26' Scl 220th ST SIN & 5T Ecl Hwy 99
Mountlake Terrace, 4AIA 98026
DURATION OF WORK
APPROXIMATELY 15 MINU ES
HOURS OF OPERATION!
M-F, 9AM-4PM
SITE PLAN 41587799
BETTY FRANK
Engineering Assistant
P 'S IIF
/11
s
NOT TO SCALE
TRAFFIC CONTROLPLAN; t#1 OF i
WORK 11\I INTERSECT ION
I:I-ASON, PREFORM YEARLY
READ AT TEST LEAD WIRE BOX
i
uger oun _nergy 1 /
Corrosion Protection Dept. T-19L 28" TRAFFIC
Ceti 9 206-396-9244 COPIES
Email: betty.frankCa
rrrrrrrrrrr _,
1
220 I H ST SW
Appftant shall tepaWnphan all dan►apt is ---�-� rrrrrrrrrrrrr�r !� r i.0 - z
lltillties arlmntase IntprNmr,ents M i:k ACTIVITY
tiQh .VmyparCityst wardatwit lsemow ATTACH SIGN 165' 100, / / / AREA
cu oraorsdurilgftpeffr0edp"ad- SEQUENCE (A) TAPER TANGENT 100,
SIGN SEQUENCE A SPACING TABLE / / M1 '' TANGENT
1` I`i lilGCh�il ��r.;1DP ?S �;E 'C?tiSI LE r t X 2OO'�I- / / 4%ONS7Ql7LTtotj HOl1�RS l.1MlTJfIi Tt9
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I rlDSiU4 0ITRCz , I 01144tPIAGc X X X / a eoA1'1 TD 3 peplvt wcarKAWs
Iu oD,4M ^t 0 Q: opP+4 SAZ UR[a4V
/ / / 165' T-19L
ROAD
WORK TAPER
AHEAD
RIGHTLNE
W20-1 ttosAHE�Eo W4-2L �f(�
PPROVEQ AS NOSED ATTACH SIGN
W20-5R BYE INEERING SEQUENCE (A)
NOTES: _
SERVICES
1. MAINTAIN A MINIMUM OF ONE ACCESS POINT FOR — -- -- FEELIPE J. MACIAS FFIC CONTROL
EACH BUSINESS WITHIN WORKAREA LIMITS. iaak OFFICE 5)6583656 aI
2. ALERT METRO TRANSIT PRIOR S IARI OF WORK. Cats' P OFFICE#(425)6583656
NOVEMBER 24, 2014
yew-1fl WWO'T A019Mt-IIES *'10 �1Hv�a-S 1N 4b%)hWGe of wo%,
00 kk 1 (:*AA A`4 'Rot
— cAN-[A{,-r soNNiE Nm (20(*tgo-L1N)1
CHANNELIZJNG DEVICES SPACING (FEET)
MPH
TAPER
TANGENT
20/30
20
40
220 St SW & Hwy-99
Job# 887033545 / TS-034202
220 St SW & Hwy99
Job# 887033545 TS-034202
TS-034202 —street view
showing location of wire box
at 220 St SW & Hwy-99