ROW PERMIT ENG20180532.pdf,t F", b
CI
T v EDMONDS
I�
121 5TH A VENUE NORTH - EDMONDS, WA 98020
;lie PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20180532
RIGHT OF WAN" PERMIT (6-EUC)
Permit Number: ENG20180532 Expiration Date: 05/21/2019
Job Address: 18811 OLYMPIC VIEW DR, EDMONDS Location: 18811 OLYMPIC VIEW DR
APPLICANT CONTRACTOR
PSF/Infras ource P SE/Infraso urce
C/O Susan att: Sidick C/O Susan att: Sidick
1660 Park Lane 1660 Park Lane
Burlington, WA 98233 Burlington, WA 98233
(425)457-6353
LICENSE 4: infrasl871c2 EXP: 02/22/2019
1'
Work area is approx 14' W to 12' E c/I of Olympic View Dr. Also, 10' S c/l of Wharf St. (1) 3'x5' paving cut anticipated and (1) 3'x5'
paving / gravel cut anticipated.
ASSESSED VALUE: KOO PROPERTY AREA: 0
SIDEWALK: (OXO) DURATION IN MONTHS: 0 FEE: $0.00 STREET DISRUPTION TRENCH CUT: ( 3 X 5 }
PARKING ( OXO) DURATION IN MONTHS: 0 FEE: $0,00 YEAR OF OVERLAY: 0 FEE: WOO
ALLEY: ( OX0 } 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 OFTHE W ORK
• 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 (1-800-424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT.1326
24 HOUR NOTICERI! UIRED FOR ALL INSPECTION REQUESTS
THIS APPLICA"LION IS NOT P ERMIT IJN'IIL SIGNED BY TIIE C I'IY ENG[NEER OR HISMER DEPUTY: AND FEES ARE PAID, AND RECEIP'rIS ACKNOWLEDGED IN
SPACE PROVIDED
RELEASED BY
Printed: Wedne day.November21.201
DATE
❑ FILE COPY INSPECTOR COPY ❑ APPLICANT COPY
STATUS: ISSUED
ENG2O18O532
• 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 from temporary construction sites as a result of construction activity are exempt from the noise limits
of ECC Chapter 5.30 only during the hours of 7:00amto 6:OOpm on weekdays and 10:OOam and 6:OOpm 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 from the issuance ofthis pemrit.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
• E-Final restoration limits
• E-Engineering Final
PARTIAL INSPECTION DATE: INITIAL: NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTI"&
FINAL INSPECTION APPROVED DATE: INITIAL:
ROW 1ISSU DATE: t C��
RIGHT-OF-WAY CONSTRUCTION
PERMIT A:P'PLICATION
PROJECT NAME: 106349052 CONTACT: Sue Sidick
CONTRACTOR: PSE/Infrasource
Mailing Address: 1660 Park Lane, Burlington, WA 98233
State License #: INFRASL871 C2
City Business License #: NR-025677
Phone #: 425-457-6353
Fax #:
Email #: Susan.Sidick@pse.com
❑ Liability Insurance ❑ Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 18811 Olympic View Dr
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
[] Commercial [l 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?
❑ Other
❑ Yes 0 No
ANY ASSOCIATED PERMITS? BLD# ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) : Work area is approx 14' W to 12' E c/1
of Olympic View Dr also 10' S c/I of Wharf St ( 1) 3x5 paving cut anticipated and (1) 3x5 paving / gravel cut anticipated
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES0 NO Year: 106�
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 1 DURATION
AREA TOTAL
CLOSURE (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.
SIGNATURE Susan Sidick A" ��'� �"���"���°°°�" ""M°
0001 �,��, �a �� ° DATE 11 /14/2018
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Job #:
Date:
Jurisdiction:
ROW Permit:
Est. Start Date:
Est. Duration:
106349052
9/24/18
EDMONDS
Yes
1/21/18
1 Days (8 Hours)
Puget Sound Energy Gas Pre -Inspect Form
Address:
City / Zip:
Customer:
PM / Inspector:
18811 OLYMPIC VIEW DR
EDMONDS 98020
SUSAN EMMONS 425-232-1812
Kevin Williams 425-398-61192
Jab Description / Scope of Work
From 2" PE main run new complete 1 1/8 PE service to single family home(42' scat stub with 80'
New Construction:
scat extension) set AL-425 meter OL @ Inches
no
Construction Method
All Scat / Trenchless
PLAT Map: 161.067
'I i /9' M,PE
,5:d�'" V PE
18717
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77
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1809
e0Wss
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LU
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18823
18819
CL-
82 MPE
199 PE
994
20D
2000
Work Location
Size of Cut Surface Type
14'
W
I of CL
Olympic View DR
&
10'
S
of CL
Wharf ST
US
As halt
12'
E
o CL
Olympic View DR
&
10'
S
o CL
Wharf ST
U6
Asphalt/Gravel
of CL
&
of CL
of CL
&
of CL
of CL
& of CL
Service
Information
Street Information
Job Type
Diameter:
1.1/8" PE
I FI'aggers #: Arterial:
New Residential Svc
EFV:
1-1/8" - 2600 - 9999144
1 Police #:
TCP:
Yes
Tie -In Fitting
Meter:
A425
Speed Limit:
25
No Parks #:
4
Meter Loc:
04 - OL (rear)
Trolley Lines:
Mtr Hoods M
Del Press:
6`1 W.C.
Traffic Signal:
Bus Stop:
Bollards:
1 2.5" # 4" #
ADA Ramps M
Route #'s:
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