ENG2020-0207RIGHT OF WAY EUC PERMIT
PERMITNUMBER,
City of Edmonds
• ••� 1 1 1 1
www.cityofedmonds.gov
Description: PSE-EMERGENCY GAS LEAK REPAIR ISSUED: 06/04/2020
Address: 18328 73RD AVE W EDMONDS WA 98026-5519
EXPIRES: 12/04/2020
Permit Type: RIGHT OF WAY EUC Permit Subtype: MINOR Parcel Number: 00477500006800
NAME TYPE NAME ADDRESS PHONE
APPLICANT PSE/INFRASOURCE 1660 PARK LANE, BURLINGTON WA 98233 (425)457-6353
CONTRACTOR PSE/INFRASOURCE 1660 PARK LANE, BURLINGTON WA 98233 (425)457-6353
OWNER HELSETH LYNN C 18328 73RD AVE W, EDMONDS WA98026-5519 (206)349-6021
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE CHARGED PER PERMIT $40.00 $0.00
ENGINEERING INSPECTION FEE $110.00 $0.00
RIGHT OF WAY MINOR - EUC PERMIT FEE $110.00 $0.00
•
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
06/04/2020
:»•>/F9:1H ]1
DATE
Printed: Thursday, June 04, 2020 9:41:53 AM 1 of 2
-1RRRTF WAY EUC PERMIT
PERMIT NUMBER
City of Edmonds
www.cityofedmonds.gov• •
CONDITIONS
CONDITION TYPE
Easement and/or permission from adjacent property owner is required prior to entry or work within
ADJACENT PROPERTY
an adjacent property.
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.
Contractor/Owner shall be responsible for repair/replacement of all damage to utilities and/or
DAMAGE TO FRONTAGE
frontage improvements in city right of way per city standards that is caused by or occurs during the
IMPROVEMENTS
permitted project.
ALERT AFFECTED RESIDENTS AND/OR BUSINESSES PRIOR TO WORK START.
ENGINEERING OTHER
VERIFY CLEAR BORE CROSSINGS.
RESTORE LANDSCAPE TO LIKE OR BETTER CONDITIONS.
CALL FOR REQUIRED INSPECTIONS AS NOTED.
ESC REQUIRED
Maintain erosion & sediment control per city standards.
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
HOLD HARMLESS
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 nor limit in any way the City's ability to enforce any ordinance provision.
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
SOUND OR NOISE
weekdays and 10:OOam to 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.
UNDERGROUND UTILITY
Call for locates of underground utilities prior to any excavation.
LOCATES
F
'ENGINEERING
OF
INSPECTION TYPE DATE
RESULT
NOTES
COMPLETE
X-2 FINAL"
E-7 RESTOR LIMITS
Printed: Thursday, June 04, 2020 9:41:53 AM 2 of 2
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"VC. I S'� J
PROJECT NAME:
CONTRACTOR:
RECEIVED 6/1/20
ROW PERMIT NO.: ENG2020-0207
ISSUE DATE: 6/4/20
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
109129854 CONTACT: Susan Sidick
PSE/Infrasource Phone #: 425-457-6353
Mailing Address:1660 Park Lane Burlington Wa 98233 Fax #:
State License #: INFRASL871C2 Email #: susan.sidick@pse.com
City Business License #: ❑ Liability Insurance ❑ Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 18328 73 AVE W
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
❑ Commercial ❑ Subdivision ❑ City Project ❑ Traffic Control (Only)
❑ Multi -Family ❑ 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) : Emergency gas leak repair follow up at approx
622' N c/1 of Olympic View Dr & 18' W c/1 of 73rd AVE W. (1) 2x4 paving cut
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES ❑ NO ❑ Year:
PAVEMENT CUT: ❑x Yes ❑ No If yes, indicate size of cut: 2 x 4
CONCRETE CUT: ❑ Yes ❑ No If yes, indicate size of cut: x
RIGHT-OF-WAY
CLOSURE
AREA
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.
SIGNATURE Susan Sidick DATE 06/01/2020
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 012238
Card Exp. 09/30/2023
gregory.harwood@pse.com
(425)424-6425
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18328
END ROAD WORK
LEGEND
®
28" TRAFFIC CONE
®
WORK PIT
TRAFFIC FLOW
TfFLAGGER
WORK VEHICLE/
FLASHING LIGHTS
SIGN LOCATION
RIGHT OF WAY
ROW
TEMPORARY TRAFFIC CONTROL PLAN
182ND ST S2W
E—
N
OLYMPIC VIEW DR
SIGN SPACING
MPH
"X"
60/65
1000,
45/55
500,
35/40
350'
30
200'
25
1 100'
END ROAD WORK
PUGET
SOUND
ENERGY
JOB# 109129854
18320 73RD AVE W, EDMONDS, WA 98026
05/29/20
JOHN.CROFOOT@PSE.COM
425-424-6658
SHEET 1 of 1
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 06/03/2020
PLACE SIGNS ALONG
WORK AREA
a
-■ o
N
W3-4
d-
NE LANE p
ROAD N
AHEAD
WORK
CHANNELIZATION
DEVICE SPACING
MPH
TAPER
TANGENT
55/70
40
80
35/45
30
60
25/30
20
40
Notes:
C\1
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 622' NCL of Olympic View Dr and 18'
WCL of 73rd Ave W.
9. If used, place NO -PARK signs 72 hours in
advance of the day that the work is to be done.
Job #: 109129854
Date:
Jurisdiction: Edmonds
Right of Way Permit? I YES ❑ No
Est. Start Date:
Gef ni irnfinn-
PRE-INSPECTION REPORT
Address: 18328 73rd Ave W
City / Zip: Edmonds
Customer:
P E R
PM / Insp:
PHONE NUMBER
Construction Method
WORK DESCRIPTION: -- 1 0 A1 � (==,,R
Open Trench ❑
r d rC)
Trenchless P]
I PLAT MAP:
f®
ofCL oi
- 'NSofCL
'N S of CL
FLAGGERS � a 5__ MPH
❑ OFFICERS #
SPEED LIMIT
❑ Commercial
❑ Altered Commercial
Residential
❑ Altered Residential
Multi -Family
Replacement Service
❑ New Constr.
❑ Main Maintenance
❑ Stub
❑ Service Maintenance
❑ Extension
❑ valve Maintenance
❑ Compete Sery
❑ Cut & Cap
Met(
l,J1 3 xo�'./.
250
425
El11/4" El630
El2" El1000
Mtr Loc:
�1
❑ METER HOODS #
❑ NO PARKS #
❑ Template Bar
EFV ❑ Bollards 2.5" #
El1800 ❑ Bollards 4" #
2600
❑ 10,000 FUEL LINE PERMIT NEEDED
Fuel Line Length:
Fuel Line Diameter: