ENG2019-0487RIGHT OF WAY EUC PERMIT
PERMIT NUMBER
of Edmonds
EdmondsCity
•:0.
www.cityofedmonds.gov
Description: PSE Emergency follow up: 7 day investigation. Replaced 139 ISSUED: 05/04/2020
Address: 913 12TH PL N EDMONDS WA 98020-2938
EXPIRES: 11/04/2020
rmit Type: RIGHT OF WAY EUC Permit Subtype: MINOR Parcel Number: 00507000000500
i
NAME TYPE NAME ADDRESS PHONE
APPLICANT PSE/Infrasource 1660 Park Lane, Burlington WA98233 (360)333-9461
CONTRACTOR PSE/Infrasource 1660 Park Lane, Burlington WA98233 (360)333-9461
OWNER MARK E CUNNINGHAM 913 12TH PL N, EDMONDS WA98020
FEE INFORMATION
DESCRIPTION AMOUNT PAID
ENGINEERING INSPECTION FEE
$100.00
ENGINEERING INSPECTION FEE
$100.00
$0.00
ENGINEERING REVIEW FEE - OVER 3 REVIEWS
$200.00
$0.00
RIGHT OF WAY MINOR - EUC PERMIT FEE
$100.00
X-TECHNOLOGY FEE
$35.00
REQUIREMENTS
REQUIREMENT TYPE NOTES
TRAFFIC CONTROL 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 posession.
RESTORATION 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
WARRANTY The contractor is responsible for workmanship and materials for a period of one year following
the final inspection and acceptance of the work.
INSPECTION SCHEDULING: WWW.MYBUILDING PERMIT.COM
24 HR NOTICE REQUIRED
INDEMNITY
The Applicant has signed an application which states he/she holds 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 but not limited to the defense of any legal proceedings including defense costs and attorney fees by reason of
granting this permit.
THIS DOCUMENT IS NOT VALID UNTIL FEES ARE PAID AND THE CITY ENGINEER OR HIS/HER DEPUTY HAS SIGNED BELOW
5/4/2020
VAIA-34Aall YA
DATE
Printed: Monday, May 04, 2020 11:40:34 AM 1 of 2
-1RRRTF WAY EUC PERMIT
City of • • •
•:• •ENG2019-0487
.,
CONDITIONS
CONDITION TYPE
Alert Affected Properties
Alert affected residents and/or businesses prior to work start.
Bore Crossings
Verify clear bore crossings
Conform to approved plans
Conform to approved working drawings and Traffic Control plan.
Work approved under this permit may or may not qualify as an essential or allowed activity per the
Governors Stay Home, Stay Healthy Order. Refer to the Order and the Citys website for up-to-date
information related to development activities during COVID-19. Issuance of this permit does not
COVID-19 NOTICE
certify that construction is allowed to immediately occur, and inspections may or may not be granted
accordingly. Construction activities and all required inspections will resume when the Order has been
lifted.
Damage to Frontage
Applicant shall repair/replace all damage to utilities or frontage improvements in City right-of-way per
Improvements
City standards that is caused by or occurs during the permitted project.
ESC Required
Maintain erosion & sedimentation control. Keep street clean.
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
Hold Harmless
agents from any and all claims for damages of whatever nature, arising directly or indirectly from the
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.
Inspections
Call for required inspections as noted.
Landscape Restoration
Restore Landscape to like or better conditions.
ROW Restoration
Restore ROW to City standards
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:OOam to 6:OOpm on
Sounds/Noise
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.
Traffic Control Handout
Traffic Control per approved plan and MUTCD. Refer to City of Edmonds traffic control requirements.
Underground Utility Locates
Call for locates of underground utilities prior to any excavation.
Utility Patch Restoration
Utility patch restoration to be in accordance with Edmonds Standard detail E2.3
INSPECTIONS
INSPECTION TYPE
DATE
RESULT
NOTES
COMPLETE
ROW PVMT STRIPING
11/22/2019
APPROVED
12:00:00 AM
X-2 ENGINEERING FINAL"
E-7 RESTOR LIMITS
E-7 PVMT SUBGRADE
Call for insp. for sand and sealant
Printed: Monday, May 04, 2020 11:40:34 AM 2 of 2
0 5- E D'k,)O 1
ROW PERMIT NO.: ENG 2019-0487
ISSUE DATE: 5/4/2020
SOP RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: 10912687 CONTACT: Megan Carabba
CONTRACTOR: PSE/Infrasource
Mailing Address: 1660 Park Lane, Burlington, WA 98233
State License #: INFRASL871 C2
City Business License #: NR-019840
Phone #: 360-333-9461
Fax #:
Email #: megan.carabba@pse.com
❑ Liability Insurance ❑ Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 913 12th PI N
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? I I BLD# ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) : Emergency Follow Up: 7 day Investigation
Replaced 139' of 3/4" STW Stub to zero leak. 1 (413), 1 (6x10)m 1 (5x6), 1 (2x6) and 1 (2x12) hard
surface cuts were made. Job #10912687
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES ❑ NO ❑ Year:109>b
PAVEMENT CUT:
CONCRETE CUT:
N Yes 0 No
❑ Yes ❑ No
If yes, indicate size of cut: 4
If yes, indicate size of cut: —
x13
x
RIGHT-OF-WAY 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 rmit to be valid.
SIGNATURE DATE 10/21 /2019
Co tract or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
RECEIVED 3/17/20
►A
Puget Sound Energy
Traffic Control Supervisor:
Stephen R Gadke
Card No. 010741
Exp.5/31 /2021
stephen.gadke@pse.com
(425) 424-6431
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913 12TH PL N, EDMONDS
REV1 - 03/16/2020
FLAVIANA.NUNES@PSE.COM
425-424-7809
SHEET 1 of 2
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RESIDENT(S) WILL BE INFORMED
OF POSSIBLE TEMPORARY
DRIVEWAY CLOSURE
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' North of CL Vista Way & 146'
West of CL 12th PI N.
9. If used, place NO -PARK signs 72 hours in
advance of the day that the work is to be done.
LEGEND
®
28" TRAFFIC CONE
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WORK PIT
TRAFFIC FLOW
FLAGGER
WORK VEHICLE/
FLASHING LIGHTS
SIGN LOCATION
RIGHT OF WAY
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CHANNELIZATION
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TANGENT
55/70
40
80
35/45
30
60
25/30
20
40
Applicant shall repair/replace all
damage to utilities or frontage
improvements in City right-of-way
per city standards that is caused or
occurs during the permitted project.
OWNER/CONTRACTOR IS RESPONSIBLE FOR
EROSION CONTROL AND DRAINAGE
ENGINEERING DIVISION
APPROVED AS NOTED
NGriggs 04/30/2020
Puget Sound Energy
Traffic Control Supervisor:
Stephen R Gadke
Card No. 010741
Exp.5/31 /2021
stephen.gadke@pse.com
(425) 424-6431
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JOB# 892047624
913 12TH PL N, EDMONDS
REV1 - 03/16/2020
FLAVIANA.NUNES@PSE.COM
425-424-7809
SHEET 2of2
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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' North of CL Vista Way & 146'
West of CL 12th PI N.
9. If used, place NO -PARK signs 72 hours in
advance of the day that the work is to be done.
RESIDENT(S) WILL BE INFORMED
OF POSSIBLE TEMPORARY
DRIVEWAY CLOSURE
LEGEND
®
28" TRAFFIC CONE
®
WORK PIT
TRAFFIC FLOW
FLAGGER
WORK VEHICLE/
FLASHING LIGHTS
SIGN LOCATION
RIGHT OF WAY
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CHANNELIZATION
DEVICE SPACING
MPH
TAPER
TANGENT
55/70
40
80
35/45
30
60
25/30
20
40
City of Edmonds Map Title
I,
Legend
ArcSD E.G IS.STREET_CENTERLINE'
call other values>
1
2
5; 4
9; 71: 7: 8
Notes
EMERGENCY PRE -INSPECTION FORM
���/o�� /S� Address: /'Zy
Job #: a( to City/zip:
Date: P 79,1q Customer:
Jurisdiction: C- O.A CUSTOMER P0 ENU
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Work Descr►ptlon _W
Construction Method
Open Trench f
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Size of Cud
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PUGET
SOUND
ENERGY
ADDRESS:
TICKET: 5075685
PERMIT:
SHEET / OF
CHECK: CITY: REQUESTED BY:
❑ INSIDE ❑ OUTSIDE D /t'I0",tAr ❑ POTELCO [�KNFRASOURCE ❑ PSE
DRAW LOCATION OF CUT AND NUMBER IT ACCORDINGLY:
MATCH N
FROM DRAWING
ABOVE
TYPE
(SEE KEY
BELOW)
SIZE
(CALLED
OUT)
DEPTH
IN INCHES
LOCATION
SIZE
(ACTUAL
INSTALLED)
Example 1
A
2 X 8
8°
25' N CIL Test St
AA to complete
3�
S
t
q
A
SAP ORDER NUMBER: _ 10 /).G 6i Z
SAP NOTIFICATION NUMBER:
PM/PERSON RESPONSIBLE: _
FORM FILLED OUT BY:
YES
NO
TRAFFIC,,CONTROL
0'
❑ +;!
POLICE OFFICER
❑
Pi —
PLATE OVER HOLE 4❑—,
NO PARKS
❑
Er
SHALLOW, UTILITIES 0.ess7tnNisq
cCI
sL
IN RIGHT OF WAY
❑
PRIVATE PROPERTY
❑
(':``
UNDER TROLLEY LINES
❑
FINAL TIC,.KET FOR THIS JOB
❑ ,
EXTRAORDINARY NCC (OFFICE USE)
❑
LOCATE NUMBER:
DATE HOLE CLOSED:
DATE AA RECEIVED:
AA LOCATE NUMBER:
1907 02114
From: Sidick, Susan
To: Edmonds Engineering Permits; Griggs, Natalie
Subject: FW: ROW Permit App ENG20190487 Comments - 913 12th PI N 892047624
Date: Thursday, April 30, 2020 6:43:17 AM
Hi Natalie in regards to this restoration permit the holes will be filled per
your request from AA is that all that is needed. The paving ticket will have
the instructions in regards to filling the hole this will be arranged by Aa
Susan Sidick R
1660 Park Lane
Burlington Wa 98233
Cell 425-457-6353
Office 360-766-5561
SR Permit Specialist
From: Isbell, Courtney <Courtney.lsbelll@pse.com>
Sent: Wednesday, April 29, 2020 2:13 PM
To: Haddox, Barbara <Barbara.Haddoxl@_pse.com>; Roger, Libby <Libby.Roger(@pse.com>
Cc: Sidick, Susan <Susan.SidickPpse.com>
Subject: RE: ROW Permit App ENG20190487 Comments - 913 12th PI N
Hi Ladies!
How can I ask that AA will fill the test holes following the City's request? They want them filled with
sand and capped with 3-4 inches of crack sealant.
Please let me know if this can be arranged with AA.
Thanks!
Courtney Isbell
Engineering Specialist, Gas Construction
PUGET SOUND ENERGY
253-617-6028 (85-6028)
253-293-0216
11705 83rd Ave SW
Lakewood, WA 98498-5501
From: Sidick, Susan <Susan.SidickCcDpse.com>
Sent: Wednesday, April 29, 2020 8:53 AM
To: Isbell, Courtney <Courtney.Isbell(@pse.com>
Subject: FW: ROW Permit App ENG20190487 Comments - 913 12th PI N
Importance: High
Hi Courtney they are not satisfied with the tar answer can you confirm they wil
be sanded and filled see email below
Susan Sidick X
1660 Park Lane
Burlington Wa 98233
Cell 425-457-6353
Office 360-766-5561
SR Permit Specialist
From: Edmonds Engineering Permits <EngineeringPermits(@edmondswa.gov>
Sent: Wednesday, April 29, 2020 8:36 AM
To: Sidick, Susan <Susan.Sidick(@pse.com>
Subject: RE: ROW Permit App ENG20190487 Comments - 913 12th PI N
CAUTION: This email originated from outside of the organization. Exercise extra caution when
responding, opening attachments, and clicking links.
Hi Sue,
I consulted the City Engineer with this one, and he was not satisfied with the tar alone. Please
confirm that the holes can be filled with sand and capped with 3-4 inches of crack sealant (meeting
WSDOT standards).
Thanks,
Natalie
City of Edmonds, Engineering Division Permitting
EngineeringPermits@edmondswa.gov
Natalie Griggs, Engineering Technician
(425) 771-0220 ext. 1353
CITY HALL IS CURRENTLY CLOSED TO GENERAL PUBLIC ACCESS.
APPOINTMENTS MAY BE CONSIDERED FOR SPECIAL CIRCUMSTANCES.