ENG2020-0451RIGHT OF
WAY EUC PERMIT
PERMITNUMBER,
City
of Edmonds
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www.cityofedmonds.gov
Description: PSE-INSTALL GAS SERVICE
ISSUED: 11/12/2020
Address: 8709 188TH ST SW EDMONDS WA 98026-5921
EXPIRES: 05/12/2021
it Type: RIGHT OF WAY EUC Permit Subtype: MINOR Parcel Number: 00434600001602
W
I 11-1411 a
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 MICHKA NICK
8709 188TH SW, EDMONDS, WA 98020
FEE INFORMATION
DESCRIPTION
AMOUNT
PAID
CITY TECHNOLOGY FEE CHARGED PER PERMIT
$40.00
$0.00
RIGHT OF WAY MINOR - EUC PERMIT FEE
$110.00
$0.00
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
G 7��'�.`Zu�r� 11 /12/2020
RELEASED BY DATE
Printed: Thursday, November 12, 2020 9:10:00 AM 1 of 2
-KRWOF WAY EUC PERMIT
City of • • •
Ave•:• •ENG2020-0451
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: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
!IMOL
INSPECTION TYPE DATE RESULT NOTES
lip
COMPLETE
X-2 ENGINEERING FINAL**
Printed: Thursday, November 12, 2020 9:10:00 AM 2 of 2
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RECEIVED 11/6/20
ROW PERMIT NO.: ENG 2020-0451
ISSUE DATE: 11/12/20
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: 106371611 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: 8709 188 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) :
To install gas service at approx 20' N c//1 of 188th ST SW & 304' E c/l of 88th AVE W
(1) 4x5 gravel cut anticipated
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES ❑ NO ❑ Year:
PAVEMENT CUT: ❑ Yes ❑ 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 Susan Sidick DATE 11/06/2020
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Puget Sound Energy
Traffic Control Supervisor:
Ina Ustemchuk
Card No. 010768
Card Exp.06/30/2021
ina.ustemchuk@pse.com
(425)398-6063 n
®
28" TRAFFIC CONE
®
WORK PIT
TRAFFIC FLOW
FLAGGER
WORK VEHICLE/
FLASHING LIGHTS
SIGN LOCATION
RIGHT OF WAY
ROW ROW
CHANNELIZATION
DEVICE SPACING
MPH
TAPER
TANGENT
55/70
40
80
35/45
30
60
25/30
20
40
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TEMPORARY TRAFFIC CONTROL PLAN
RESIDENT(S) WILL BE INFORMED
OF POSSIBLE TEMPORARY
DRIVEWAY CLOSURE
188TH ST SW
8709
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SPACE FOR SIGNS
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BOTH SIDES OF
WORK AREA
a
llotes:
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
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5. Crew is reauired to leave a minimum of 11' for
hall
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 20' NCL of 188th St SW & 304' ECL
o z o aio � i of 88th viol - -
���'"�IMt, '�PARK signs 72 hours in
advance of the day that the work is to be done.
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PUGET
SOUND
ENERGY
JOB# 106371611
8709 188th St SW, Edmonds, WA
October 28, 2020
ina.ustemchuk@pse.com
(425)398-6063
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Job #:
Date:
Jurisdiction:
ROW Permit:
Est. Start Date:
Est. Duration:
Puget Sound Energy Gas Pre -Inspect Form
106371611
10/27/20
EDMONDS
No
1/11/21
1-112 Days (12 hours)
Address:
City / Zip:
Customer:
PM / Inspector:
8709 188TH ST SW
EDMONDS, 98026
MICHELLE DORMAN 425-778-4417
Kevin Williams 425-691-7573
Job Description / Scope of Work
From 2" STW main run new complete 1-1/8 service to SFH (10 scat stub with 120' scat ext) Set
New Construction:
250 meter OR @ Inches. -CP install 20# anode and test leads-
No
Construction Method
All Scat / Trenchless
PLAT Map:
160.068
98 E
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Work
Location
Size of Cut
Surface Type
20'
N
of CL
188th ST SW
&
304'
E
of CL
88th AVE W
4x5
Gravel
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:
A250
Speed Limit:
25
No Parks #:
Steel - 1" Sery x 1/8" PE Outlet
(MOP) - 125 (3/4" Cutter)
Meter Loc:
07 - OR (rear)
Trolley Lines:
Mtr Hoods #:
Del Press:
6" W.C.
Traffic Signal:
Bus Stop:
Q
Bollards:
2.5" #
1
1
4" #
ADA Ramps #:1
1 Route #'s:
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