ENG2020-0386RIGHT OF WAY EUC PERMIT
PERMIT NUMBER
City of Edmonds
-0386
www.cityofedmonds.gov
Description: PSE ANNUAL VALVE MAINTENANCE INSPECTION ISSUED: 10/06/2020
Address: 7212 220TH ST SW EDMONDS WA 98026-8014
EXPIRES: 10/06/2021
it Type: RIGHT OF WAY EUC Permit Subtype: MINOR Parcel Number: 27042900301800
I 11-1411 a
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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 AMON-EDMONDS INVESTMENT LLC 1000 2ND AVE STE 3230, SEATTLE WA 98104
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.
RELEASED BY
THIS DOCUMENT IS NOT VALID UNTIL FEES ARE PAID AND THE CITY ENGINEER OR HIS/HER DEPUTY HAS SIGNED BELOW
DATE
Printed: Tuesday, October 06, 2020 12:03:51 PM 1 of 2
-KRWOF WAY EUC PERMIT
PERMIT NUMBER
City of • • •
www.cityofedmonds. ov/425.771.0220
CONDITIONS
CONDITION TYPE
Easement and/or permission from adjacent property owner is required prior to entry or work within
ADJACENT PROPERTY
an adjacent property.
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.
Verify clear bore crossings.
ENGINEERING OTHER
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 7:00am to 6:00pm on
SOUND OR NOISE
weekdays and 10:00am to 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.
UNDERGROUND UTILITY
Call for locates of underground utilities prior to any excavation.
LOCATES
!IMOL
INSPECTION TYPE DATE RESULT NOTES
lip
COMPLETE
X-2 ENGINEERING FINAL**
E-7 TRAFFIC CTRL
Printed: Tuesday, October 06, 2020 12:03:51 PM 2 of 2
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ROW PERMIT NO.: ENG
ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: 887033545 CONTACT: Susan Sidick
CONTRACTOR: PSE/Infrasource Phone #: 425-457-6353
Mailing Address:1660 Park Lane Burlington Wa 98233 Fax #:
State License #: INFRASL871c2
City Business License #:
Email #: Susan.sidick@pse.com
❑ Liability Insurance ❑ Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 7212 220th St SW
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) : Yearly valve maintenance inspection
TS-034202 at test lead wire box located at 26' Scl of 220 St SW & 57' Ecl hwv99
No paving cuts 15 minutes for valve inspections
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES ❑ NO ❑ Year:
PAVEMENT CUT: ❑ Yes ❑x No If yes, indicate size of cut: x
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 Qnsan Cidirk DATE 06/1 1 /?O'?o
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
PUGET SOUND ENERGY N
LEGENDS
PROJECT LOCATED AT g�"FE
26' Scl 220th ST SW & 57' Ecl Hwy 99 =�e =e o NOT TO SCALE
Mountlake Terrace, WA 98026 P DIRECTION TRAFFIC CONTROL
L
DURATION OF WORK TEM .TRAFFIC PLAN #1 OF 1
APPROXIMATELY 15 MINUTES DIRECTION
HOURS -4 OPERATION _ _ _ ___ _ TVMRK_IN I_NT_ERSECTID�I__,
M-F, 9AM-4PM c o 0 o a �EAII�IEt�LI1�G c' REASON, PREFORM YEARLY
�. bEVICE READ AT TEST LEAD WIRE BOX
BETTY FRANK /ADVANCE WARNING /
Engineering Assistant "PP'��v�� ~ fir o'�'�ON /
Puget Sound Energy
c /
Corrosion Protection Dept. T-19L 28"TRAFFIC
Cell # 206-396-9244 CONES
Email: b frank@pse.com G20-2
TS-034202 .
220TH ST SW
G
////////////.TIV[TY
ATTACH SIGN 165' 100, / / / EA
SEQUENCE (A) TAPER TANGENT 100'
SIGN SEQUENCE A SPACING TABLE / / 3 /fJ TANGENT
w I. N X 200'+/-
X X X
ROAD / / / 165' T-19L
TAPER
WORK / / /
AHEAD
<1
RIGHT LANE
W20-1 CLOSED W4-2L
AHEAD /
ATTACH SIGN
W20-5R SEQUENCE (A)
NOTES:
�ON51R C10 NO AS h�1EE10 SERVICES
1. MAINTAIN A MINIMUM OF ONE ACCESS POINT FO FELIPEJ.MACIASLTCS#0 2689
EACH BUSINESS WITHIN WORK AREA LIMITS, itickrcRtraccontolsarvlcasnet
p�� u OFFICE # (425) 658.M6
2. ALERT METRO TRANSIT PRIOR START OF WORK, IVII� Ph�NJEEuEAV NOVEMSER24,2014
CHANN✓;LlZING DEVICES SPACING (FEET)
MPH
TAPER
TANGENT
20/30
20
40
Date of Request:
Job number:
Job address:
Project mgr:
PM email:
PERMIT REQUEST FORM
06/10/20
887033545
7212 220th St SW
Betty Frank
betty.frank@pse.com
Estimated job start date:
09/01 /20
Estimated job completion date: 09/01/20
City: Edmonds Zip.
PM contact #. (206) 716-2641
Description of work to be performed:
Perform yearly inspection for TS-034202 at test lead wire box located at 26' Scl of 220 St
SW & 57' Ecl hwy99
Pavement cut? ❑Yes ❑✓ No
If yes, Dimensions of Cut: Length_
How many cuts?
Surface Type n/a
Require trenching? Dyes ❑No
If yes, Dimensions of trench: Length_
Width
Width
Depth
Method of installation:
Traffic impact:
Road closed ❑Yes ❑ No
Lane closed [?]Yes ❑ No How Many? 1 Direction? East
Shoulder closed Eyes ❑ No
Sidewalk closed ❑Yes ❑ No
Emergency Contact: John Rockford Print Send
Cell Number: (206) 255-2704
Reset
220 St SW & Hwy99
Job# 887033545 TS-034202
TS-034202 —street view
showing location of wire box
at 220 St SW & Hwy-99
7i85 I?,th S! SW !IpR4ka Tenaca. WaaMpon. Urcted Starts
NOW
•
Test Lead wire box location:
26' Scl 220 St SW & 57' Ecl
Hwy-99
220 St SW & Hwy-99
Job# 887033545 / TS-034202
F
S
Location: 2611 Scl 220 St SW & 5711 Ecl Hwy-99
Work Description: Perform yearly maintenance and get read
• test lead wire box
t
` Excavation : No digging or cutting
Lane Closure: 1 Eastbound lane of 220 St SW
,I Duration: 15 mins
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SOUTH
!ite ofi�lountlake Terrace � � � �j
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