Issued ROW Permit.pdfy of ED "o
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
o PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20190059
I RIGHT OF WAY PERMIT (6-EUC) I
Permit Number: ENG20190059 Expiration Date: 08/22/2019
Job Address: 8312 SIERRA DR, EDMONDS Location: 8312 SIERRA DR
I
PSE/Infras ource
P SE/In frasource
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 #: infrasl871 c2 EXP: 02/22/2019
Work area is approx 15' N to 15' S c/l of Sierra Dr & 177W c/l of 83rd Pl W. (2) 3x5 soft surface cuts anticipated to install gas service
DISRUPTION INFOIZMATION
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
attorney fees by reason ofgranting this permit.
THECONTRACTOR IS RESPONSIBLEFOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONEYEAR FOLLOWING THEFINAL
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 permit application.
CALL DIALrA-DIG(1-800424-5555) BEFOREANYEXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT.1326
24 HOUR NOTICE REQUIRED 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: Friday, February 22. 201
DATE
❑ FILE COPY ❑ INSPECTOR COPY ❑ APPLICANT COPY
STATUS: ISSUED
ENG20190059
• 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.
• Confonn to approved working drawings and Traffic Control plan.
• Verify clearbore 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 pemvtted 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 othertimes the noise originating from construction sites/activities must comply with the
noise limts of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120.
• Applicant, on behalf of his orher 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-Engineering Final
PARTIAL INSPECTION
PARTIAL INSPECTION
FINAL INSPECTION APPROVED
DATE: INITIAL: NOTES:
DATE: INITIAL: NOTES:
DATE: INITIAL:
Puget Sound Energy Gas Pre -Inspect Form
Job #:
106352145
Date:
2/6/19
Address:
Jurisdiction:
Edmonds
City / zip:
ROW Permit:
Yes
Customer:
Est. Start Date:
4/1/19
PM / Inspector:
Est. Duration:
1 Day (8 Hours)
8312 SIERRA DR
EDMONDS. 98026
KEITH BROWN (206) 261-3902
Brian Buschbom (425) 659-0673
Job Description
Scope of Work
Off of Sierra Drive - Install an all scat 1-1/8" PE service ( 45' Stub / 25' Ext) and then set an A250
New construction:
O/R.
No
Construction Method
All Scat / Trenchless
PLAT Map: 161069
1
P/L
2" PE IP 15W
920140
Sierra DR
w
o w
C/L : a
45'
1-1/8" PE
o �
Water Main 15'S
P/L
VG{�\t`i LLt�n-'�5on-t C.2o�S/o1JC�S ZS
1` V �C IR'[ I CAL S EPA47-ArI10/Q rRfiM
A250 MSA
8312
Work Location
Size of Cut
Surface Type
15'
North
of CL
Sierra DR
&
177'
West
of CL
83rd PI W
3'x5'
Soft
15'
South
of CL
Sierra DR
&
177'
West
of CL
83rd PI W
3'x5'
Soft
of CL
&
of CL
Of CL
&
of CL
of CL
&
of CL
Service Information
Street Information
Job Type
Diameter:
1-1/8" PE
Flaggers #:
Arterial:
New Residential Svc
EFV:
1-1/8" - 2600 - 9999144
Police #:
TCP:
Tie -In Fitting
Meter:
A250
Speed Limit:
No Parks #:
HDPE - 2" IPS - (DIA) 1"CTS
Meter Loc:
08 - OR
Trolley Lines:
Mtr Hoods #:
Del Press:
6" W.C.
Traffic Signal:
Bus Stop:
Bollards:
2.5" # 4" #
ADA Ramps #:1
1 Route #'s:
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 008997
Card Exp. 08/13/2019
gregory.harwood@pse.com
a N
� N
vu
' o
0
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 betweer-la.m. and 49p.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 15' NCL of SIERRA DR & 190' ECL
of 84TH 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
t,-OZM
E `dL-OZM W L -OZM
�Q
SIERRA DR
100' 100' 100'
PUGET
SOUND
ENERGY
JOB# 106352145
8312 SIERRA DR, EDMONDS, WA
FEBRUARY 11 TH 2O19
• Lii • �
N------- N - OWN.-,
rf
'X X CREW SHALL POTHOLE
RECEIVING PIT FOR WATER MAIN DEPTH 12� 12 0
PRIOR TO PROJECT START d
0-7A F
#8312 i. BE
EPARE
io°p 3 '� �\R
ROAD
WORK N
AHEAD
john.herman@pse.com
425-424-7807
SHEET 1 of 2
APP�VEED AS !`01
CHANNELIZATION
DEVICE SPACING
MPH TAPER TANGENT
55/70 40 80
35/45 30 60
25/30 20 40
LEGEND
®
28" TRAFFIC CONE
WORK PIT
TRAFFIC FLOW
FLAGGER
WORK VEHICLE/
FLASHING LIGHTS
SIGN LOCATION
RIGHT OF WAY
ROW
ROW-
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 008997
Card Exp. 08/13/2019
gregory.harwood@pse.com
(425)424-6425
N
0
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. and 49p.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 15' SCL of SIERRA DR & 190' ECL
of 84TH 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
SIERRA DR
3-Lt
7 b OZM
`dL-OZ w
ao
100'f ioo'
a N 7
PUGET
SOUND
ENERGY
JOB# 106352145
8312 SIERRA DR, EDMONDS, WA
FEBRUARY 11 TH 2O19
N /
john.herman@pse.com
425-424-7807
SIGN SPACING
CHANNELIZATION
DEVICE SPACING
MPH
'X.
60/65
1000,
MPH
TAPER
40
TANGENT
80
45/55
500'
55/70
35/40
350'
30
60
30
200'
35/45
25
100'
25/30
20
40
SHEET 2 of 2
LEGEND
®
28" TRAFFIC CONE
�f
WORK PIT
TRAFFIC FLOW
TtFLAGGER
WORK VEHICLE/
FLASHING LIGHTS
SIGN LOCATION
RIGHT OF WAY
ROW ROW-
-( Of EVAf
Cti� ti�J,
ANC. 1 S9�
�E,:.0 .NJIS: D
�E� 12 201g ROW PERMIT NO.: ENG 20 i c1 OC) 51
ENGINEEOL' ONISIO14 ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: 106352145
CONTRACTOR: PSE/Infrasource
Mailing Address: 1660 Park Lane, Burlington, WA 98233
State License #: INFRASL871 C2
City Business License #: N R-025677
CONTACT: Sue Sidick
Phone #: 425-457-6353
Fax #:
Email #: Susan.Sidick@pse.com
❑ Liability Insurance ❑ Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 8312 Sierra Dr
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 15' N to 15' S c/1 of
Sierra Dr & 177' W c/1 of 83rf PL W (2) 3x5 soft surface cuts anticipated
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES ❑ NO ❑ Year: 106B
PAVEMENT CUT: ® Yes ® No If yes, indicate size of cut: x
CONCRETE CUT: ElYes ❑ No If yes, indicate size of cut: x
RIGHT-OF-WAY
AREA
CLOSURE
TOTAL
DURATION
(NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF
X LF
X LF
SF
Alley 72 Hrs + 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 Sidick Drei,3 ° a4
DN:1imt -SM, —VAax Dm,-Unl,o�=Muniupal 02/12/2019
SIGNATURE D.'.:' """10111 npv.om,°=NS DATE
Daie::oio n: 1: m m u tnar
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE