ENG2020-0408OF WAY EUC PERMIT
PERMIT NUMBER
City of Edmonds
AveRIGHT
9801 1 1 1
www.cityofedmonds.gov
Description: PSE-INSTALL GAS SERVICE ISSUED: 10/28/2020
Address: 9527 190TH PL SW EDMONDS WA 98020
EXPIRES: 04/28/2021
it Type: RIGHT OF WAY EUC Permit Subtype: MINOR Parcel Number: 00434600007901
I 11-1411 a
W
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 JOHNSON CHRISTIAN A & VICKI L 20821 HILLCREST PL, EDMONDS WA 98026-6914
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.
:»•>/F9:1H ]1
THIS DOCUMENT IS NOT VALID UNTIL FEES ARE PAID AND THE CITY ENGINEER OR HIS/HER DEPUTY HAS SIGNED BELOW
DATE
Printed: Wednesday, October 28, 2020 1:16:55 PM 1 of 2
-KRWOF WAY EUC PERMIT
City of • • •
A•:•• 1 1141:
31
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
• ��
INSPECTION TYPE DATE RESULT NOTES
lip
COMPLETE
X-2 ENGINEERING FINAL**
E-7 RESTOR LIMITS
Printed: Wednesday, October 28, 2020 1:16:55 PM 2 of 2
0 \:L L?,11(7.
"'VC. I S'� J
RECEIVED 10/13/20
ROW PERMIT NO.: ENG 2020-0408
ISSUE DATE: 10/28/20
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: 106371310 CONTACT: Susan Sidick
CONTRACTOR: PSE/Infrasource Phone #: 425-457-6353
Mailing Address: 1660 Park Lane Burlington Wa 9823Yax #:
State License #: INFRASL87I C2
City Business License #:
Email #: susan.sidick@pse.com
❑ Liability Insurance ❑ Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 9527 190th PL SW
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
❑ Commercial ❑ Subdivision ❑ City Project ❑ Traffic Control (Only)
❑ Multi -Family ❑ Single Family ❑ Other
❑ EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit?
ANY ASSOCIATED PERMITS?
❑ Yes ❑ No
BLD# ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) :
To install gas service at approx 1' N c/l of Pav 190th PL SW & 165' E c/l of Olvmpic View
Dr (1) 4x5 paving/ dirt cut anticipated
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES ❑ NO ❑ Year:
PAVEMENT CUT: ❑ Yes ❑ No If yes, indicate size of cut: 4 x 5
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 10/13/2020
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Job #:
Date:
Jurisdiction:
ROW Permit:
Est. Start Date:
Est. Duration:
106371310
10/8/20
EDMONDS
Yes
12/14/20
1 Day (8 Hours)
Puget Sound Energy Gas Pre -Inspect Form
Address:
City / Zip:
Customer:
PM / Inspector:
9527 190TH PL SW
EDMONDS, 98020
Dave Peterson 206-351-7255
Kevin Williams 425-691-7573
Job Description / Scope of Work
From 2" STW main run new complete 1-1/8 PE service to SFH(30' scat stub with 40' plat
New Construction:
Yes
extension) set
AL-425 meter OR
@ Inches
Construction Method
Scat ROW / Plat Property
PLAT Map:
161.067
I
L..L
9523
I
WI
�• I
> I
I
U'
9527
425
d
O,Co
I
co
II
I ; 1-1/8" PE
LO
II
II
I
O I
II
II
II
I
!U
I -
190th PL SW
I
w
Q
C*"/Id4
7'STWIPVNPAV
T
B
u, o
Z
m
_
__5778-1963________
�
—
— - —
— — J._
Storm
z1
Work Location
Size of Cut
Surface Type
1'
N
of PAV
190th PL SW
&
165'
E
of CL
OLYMPIC VIEW DR
45
Asphalt/Dirt
of CL
&
of CL
of CL
&
of CL
Service Information
Street Information
Job Type
Diameter:
1-1/8" PE
Flaggers #:
YES
Arterial:
New Residential Svc
EFV:
1-1/8" - 2600 - 9999144
Police #:
TCP:
Yes
Tie -In Fitting
Meter:
A425
Speed Limit:
No Parks #:
Meter Loc:
0
Trolley Lines:
Mtr Hoods #:
Del Press:
6" W.C.
Traffic Signal:
Bus Stop:
Q
F2Bollards:
.5" #
4"
#
ADA Ramps #:
Route #'s:
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 012238
Card Exp. 09/30/2023
gregory.harwood@pse.com
(425)424-6425
11 �11
�IQ
I
I
I
oa
TEMPORARY TRAFFIC CONTROL PLAN
N W3-4
END o
ROAD WORK �
Q o2M-oZM
LIJ
Zyd poi
U 0
#9527
0
�
0 S2
/ - � 9 G2o-
X' X' — — -
iC �iv�-3o-3r-161� �11� �.1 s1�ia�
�i�l
a ��1 �.0�3 �o sa11J 113r� 01 a .L
11� - �Ici a�/�I�cia 11�y5 1u �vlll
�qfj
{k
- c�
C)
CD �iaoM aeon
N ON3
Ii
W20-4
W3-4
ROAD
WORK N
AHEAD
7A USE MAXIMUM AVAILABLE
SPACE FOR SIGNS
o
PLACE SIGNS
BOTH SIDES OF
WORK AREA
A
CHANNELIZATION
DEVICE SPACING
MPH
TAPER
TANGENT
55/70
40
80
35/45
30
60
25/30
20
40
LEGEND
®
28" TRAFFIC CONE
®
WORK PIT
TRAFFIC FLOW
FLAGGER
WORK VEHICLE/
FLASHING LIGHTS
SIGN LOCATION
RIGHT OF WAY
ROW
PUGET
SOUND
ENERGY
JOB# 106371310
9527 190TH PL SW, EDMONDS
10/12/2020
FLAVIANA. N U N ES@PSE.COM
425-424-7809
SHEET 1 of 1
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 1' North of PAV 190th PI SW & 150'
East of CL Olympic View Dr.
9. If used, place NO -PARK signs 72 hours in
advance of the day that the work is to be done.
Al
i . ►fir . �' � 1 1 , ; _ v ; ���
• . f `}.
ILA •..% 1 _.C� ��'!��'�•` � \5 � .�
''SS • � 11
Griggs, Natalie
From: Williams, Kevin <Kevin.Williams@pse.com>
Sent: Tuesday, October 27, 2020 3:29 PM
To: Edmonds Engineering Permits
Cc: Sidick, Susan
Subject: RE: ENG2020-0408 at 9527 190th PI SW (106371310)
Attachments: Catch Basin-LI jpg
Categories: Red category
Hello,
Yes there is over 10' of separation from the catch basin, photo attached.
Thank you!
Kevin Williams
Project Manager
Customer & System Projects - Bothell
C: 425-691-7573
E: Kevin.Williams@pse.com
20000 north creek PKWY
Bothell, WA 98011
www.pse.com
® PUGET SOUND ENERGY
From: Sidick, Susan <Susan.Sidick@pse.com>
Sent: Tuesday, October 27, 2020 3:18 PM
To: Williams, Kevin <Kevin.Williams@pse.com>
Subject: FW: ENG2020-0408 at 9527 190th PI SW (106371310)
Hi Kevin see email below
Susan Sidick R
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: Tuesday, October 27, 2020 2:56 PM
To: Sidick, Susan <Susan.Sidick@pse.com>
Subject: ENG2020-0408 at 9527 190th PI SW (106371310)
CAUTION - EXTERNAL EMAIL
Phishing? Click the PhishAlarm "Report Phish" button.
For mobile - forward to abuse@pse.com
Hi Sue,
I have reviewed the ROW permit application and have one comment. The gas service is shown in the vicinity of the
storm catch basin and storm main. Please verify that there will be at least 5' of horizontal separation between the gas
service and the storm main and catch basin.
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.
Development services will continue to be provided by email or the web and by phone.
Please visit www.edmondswa.gov for up-to-date information on City services.
For engineering permit inquiries, please email: engineeringpermits(c2�edmondswa.gov
For all other inquiries please email: devserv.admin(o)edmondswa.gov
Web Map: www.maps.edmondswa.gov