Issued ROW Permit.pdfCITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
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PHONE: (425) 771-0220 - FAX: (425) 771-0221
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*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20190051
RIGHT
Permit Number: ENG20190051 Expiration Date: 08/19/2019
Job Address: 7928 216TH ST SW, EDMONDS Location: 7928 216th St SW
PSE/Infrasource
P SE/Infrasource
GO Susan att: Sidick
C/O Susan att: Sidick
1660 Park Lane
1660 Park Lane
Burlington, WA 98233
Burlington, WA 98233
(425) 457-6353
LICENSE #: infrasl871c2 EXP: 02/22/2019
Work area is approx 19' N c/1 of216th ST SW & 3PE c/l of 80th AVE W to investigate and repair leak (1) 3x5 paving cut anticipated.
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 ofits departments or employees, including but not limited to the defense ofany legal proceedings including defense costs and
attorneyfees by reason ofgranting thispermit.
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 TIC E REQ UIRED FOR ALL INSPECTION REQUESTS
THIS APPLICATION IS NOTA PERMITUNTIL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN
SPACE PROVIDED.
BY
Printed: Tuesday. February 19.201
DATE
❑ FILE COPY ❑ INSPECTOR COPY ❑ APPLICANT COPY
STATUS: ISSUED
ENG2019O051
• 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.
• 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 lints 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 indenmify 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-Final Restoration
• E-Engineering Final
PARTIAL INSPECTION DATE: INITIAL: NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: INITIAL:
PR -INS ECTION REPORT ® I'Mi- I SOUND f,*k V
Job #: �
Date: f z • Zk . I �, ddre %92 ZI G• S �ScrJ
Jurisdiction: cGt r1s�� S ity/ p: ,,�®.-2► 5 �1802C�
Right of Way Permit? jg YES ❑ NO UStO er: '
OUST PHONE NUMBER
Est. Start Date: M / I sp:
Est. Duration: PHONE NUMBER
WORK DESCRIPTION: _T n VC : 4-1
I PLAT MAP:
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FLAGGERS # Z MPH ❑ TROLLY LINES ❑ BUS STOP # ❑ METER HOODS #
❑ OFFICERS # SPEED LIMIT ❑ TRAFFIC SIGNAL ❑ ARTERIAL ❑ NO PARKS #
❑ Commercial ❑ Altered Commercial Leak Repair Service Information ❑ Template Bar
Residential Altered Residential CP Work Diameter Meter EFV
❑ ❑_ ❑ Bollards 2.5" #
❑ Multi -Family ❑ Replacement Service L_l Pothole ❑ 5/8" ❑ 250 ❑ 1800 ❑
❑ New Constr. ❑ Main Maintenance ❑ Extension ❑ 11/8" ❑ 425 ❑ 2600 Bollards 4" #
❑ Shib ❑ Service Maintenance ❑ 11/4" ❑ 630 ❑ 10,000 ❑ FUEL LINE PERMIT NEEDED
❑ Extension ❑ valve Maintenance ❑ 2" ❑ 1000 Fuel Line Length:
❑ Compete Sery ❑ Cut & Cap Mtr Loc: Fuel Line Diameter:
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uBabiLity of Jhis _oMolarany �:_•oou.Q«ee..fopew to 4otdlsdoze this confitleni`al information scarf omeNDerion OsmMy.'
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Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 008997
Card Exp. 08/13/2019
gregory.herwood@pse.com
(425)424-6425 _
Notes:
1. All signs and spacing to conform to the MUTCD
and City of Edmonds standards.
2. All sidewalks, driveways, exits and egresses
shall be completely clear unless otherwise indicated.
3. Channelizing 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. and3 p.m
unless otherwise specified. All work for arterials
and major roadways will be from 9 a.m. to 3 p.m
8. Work area will be 19' SCL of 216TH ST SW & 31' ECL
of 80TH AVE W.
9. If used, place NO -PARK signs 72 hours in
advance of the day that the work is to be done.
TEMPORARY TRAFFIC CONTROL PLAN
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JOB# 887035416
TH ST SW, EDMONDS, WA
JANUARY 31 ST 2019
john.herman@pse.com
425-424-7807
SHEET 1 of 1
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SIGN SPACING
CHANNELIZATION
DEVICE SPACING
MPH
'X.
60/65
1000'
MPH
TAPER
TANGENT
45/55
500'
55/70
40
80
35/40
350'
35/45
30
60
30
200'
25
100'
25/30
20
40
LEGEND
28" TRAFFIC CONE
®
WORK PIT
TRAFFIC FLOW
TtFLAGGER
WORK VEHICLE/
FLASHING LIGHTS
N
SIGN LOCATION
RIGHT OF WAY
ROW ROW
s of EDAin.
"NC. 1 Sy0
ROW PERMIT NO.: ENG -Lx:S1 I
FEB 0 7 2019 ISSUE DATE:
NPE RIdfiT-8 -VIVI"AY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: 887035416 CONTACT: Sue Sidick
CONTRACTOR: PSE/Infrasource Phone #: 425-457-6353
Mailing Address: 1660 Park Lane, Burlington, WA 98233 Fax #:
State License #: INFRASL871 C2 Email #: Susan. Sid ick@a pse.com
City Business License #: NR-025677 ❑ Liability Insurance ❑ Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 7928 216th ST SW
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
❑ Commercial ❑ Subdivision ❑ City Project ❑ Traffic Control (Only)
❑ Multi -Family X❑ Single Family
❑ EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit?
ANY ASSOCIATED PERMITS?
❑ Other
❑ Yes ❑* No
BLD# ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) : Work area is approx 19' N c/I of 216th ST SW
& 31' E c/I of 80th AVE W to investigate and repair leak (1) 3x5 paving cut anticipated
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES NO Year: 887MI
PAVEMENT CUT: [:]Yes ❑ No If yes, indicate size of cut: 3 x 5
CONCRETE CUT: 0 Yes ❑ No If yes, indicate size of cut: x
RIGHT-OF-WAY
AREA
CLOSURE
TOTAL
DURATION
(NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF
X
LF
SF
Alley 72 Hrs + LF
X
LF
SF
Parking 72 Hrs + LF
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 understand the permit requirements and acknowledge that I must
follow all requirements in order for the permit to be valid.
Susan Sid i ck A.1alm� : W�: omad�US eu-M Pa 7 //� 1 Q
SIGNATURE Date: 2019020706:26:56-06'00' DATE 02/0 / /20 1 V
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE