Issued ROW Permit.pdfA Ot c MO��
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
C. 1 a`) PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20190040
RIGHT OF WAYPERN11T (6-EUC)
Permit Number: ENG20190040 Expiration Date: 08/08/2019
Job Address: 10610 240T I PL SW, EDMONDS
PSE/Infrasource
C/O Susan att: Sidick
1660 Park Lane
Burlington, WA 98233
Location: 10610 240th PI SW
P SE/In frasource
C/O Susan att: Sidick
1660 Park Lane
Burlington, WA 98233
(425)457-6353
LICENSE #: infrasl871 c2 EXP: 02/22/2019
Work area is approx 15' S c/l of 240th PI SW & 105' E c/1 of 106th P1 W. (1) 3x5 soft surface cut anticipated. Install gas service.
DISRUPTION 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 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 ofgranting this permit.
THECONTRACTOR IS RESPONSIBLEFOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONEYEAR FOLLOWING THEFINAL
INSPECTION AND ACCEPTANCE OF THE W O RK.
• 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 NOT PERMIT UNTIL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN
SPACE PROVIDED.
RELEASED BY
Printed: rriday, February 08,201
-/41Icr
DATE
❑ FILE COPY INSPECTOR COPY APPLICANT COPY
STATUS: ISSUED
ENG2O190040
• 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 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 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.
• &Final Restoration
• E-Engineering Final
PARTIAL INSPECTION DATE: INITIAL: NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: INITIAL:
Puget Sound Energy Gas Pre -Inspect Form
Job #:
106351731
Date:
1125/19
Address:
Jurisdiction:
EDMONDS
City / Zip:
ROW Permit:
Yes
Customer:
Est. Start Date:
3/25/19
PM / Inspector:
Est. Duration:
1 Day (8 Hours)
10610 240TH PL SW
EDMONDS, 98020
CHRIS LYON 425-478-9189
Kevin Williams 425-398-6192
Job Description Scope of Work
From 2" PE main run new complete 1 1/8 PE service to single family home(15' scat stub with
New Construction:
35' scat extension)set AL-425 meter OL @ Inches
No
Construction Method
All Scat / Trenchless
PLAT Map: 167.066
-CALL FOR LOC TES f
f
- VERIFY CLEAR ORE CROSSINGS
- MUST MAINTAI A MINIMUM 5' HORIZONTAL AND V VERTICAL
SEPARATION FR M CITY AND O.V.W.S.D.'S UTILITIES 240TH
PL SW
`n 2" PE 1 P 1 SS
1 91213
u'
ao
LO
cv
1 118" PE
i
5/8"
MPE
2005 LN
0�90� A425
20 i 3-
a
.r
to
T 10602
M
24103
241
I
Work Location
Size of Cut
Surface Type
15'
S
of CL
240th PL SW
&
105'
E
of CL
106th PL W
3x5
Soft
of CL
&
of CL
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:
Yes
Tie -In Fitting
Meter:
A425
Speed Limit:
25
No Parks #:
4
Meter Loc:
03 - CL
Trolley Lines:
Mtr Hoods #:
Del Press:
6" W.C.
Traffic Signal:
Bus Stop:
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 008997
Card Exp. 08/13/2019
gregory.harwood@pse.com
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 4,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 15' SCL of 240th PI SW & 105'
of 106th PI 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
0; g'
100' 100'41100.
i
r0
10610�
W20-1
20-7A
o
W20-5R W-�H
11I11
c
0
8E
EPARE j
in
o
'
TOP
ROAD
WORK CD
AHEAD
o
i
I
3-`4
`dL-OZMI /w \ I•-0ZM
�a
240TH PL S
SIGN SPACING
MPH
..X.
60/65
1000,
45/55
500'
35/40
350'
30
200'
25
100,
PUGET
SOUND
ENERGY
JOB# 106351731
10610 240th PI SW, Edmonds, WA
January 29 2019
jaber.tofan@pse.com
425-424-7808
SHEET 1 of 1
UMAININtLILA I IVINI
DEVICE SPACING
MPH TAPER TANGENT
55/70 40 80
35/45 30 60
25/30 20 40
CJL-- .II: 7-1-71101
LEGEND
® 28" TRAFFIC CONE
® WORK PIT
TRAFFIC FLOW
FLAGGER
WORKVEHICLE/
FLASHING LIGHTS
SIGN LOCATION
RIGHT OF WAY
ROW ROW-
RECEIVED
JAN 312019 ROW PERMIT NO.: ENG ?,b ict 0t)g0
- ISSUE DATE: `7- <�,� I �{
ENGINEERING DIVISION
RIGHT-OF-WAY CONSTRUCTION
,'Nc. 13e° PERMIT APPLICATION
PROJECT NAME: 106351731 CONTACT: Sue Sidick
CONTRACTOR: PSE/Infrasource Phone #: 425-457-6353
Mailing Address:
State License #:
1660 Park Lane, Burlington, WA 98233 Fax #:
INFRASL871 C2
City Business License #: NR-025677
Email #: Susan.Sidick@pse.com
❑ Liability Insurance Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 10610 240th PL SW
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
Commercial Subdivision City Project ❑ Traffic Control (Only)
❑ Multi -Family ❑X Single Family ❑ Other
❑ EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit? ❑ Yes ❑* No
ANY ASSOCIATED PERMITS? BLD# ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) : Work area is approx 15' S c/I of 240th PL SW
& 105' E c/1 of 106th PL W (1) 3x5 soft surface anticipated Install gas service
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES NO ❑ Year: 1063
PAVEMENT CUT: ® Yes ® No If yes, indicate size of cut: x
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
X LF
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 Susan Sidick DATE 01/30/2019
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE