ENG2020-0464RIGHT OF WAY EUC PERMIT
PERMIT NUMBER
City of Edmonds
...0i 1 1 1�.4
www.cityofedmonds.gov
Description: PSE-NEW GAS SERVICE ISSUED: 11/19/2020
Address: 9221 217TH ST SW EDMONDS WA 98020-3942
EXPIRES: 05/19/2021
it Type: RIGHT OF WAY EUC Permit Subtype: MINOR Parcel Number: 00612900100600
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 JAMES R 9221 217TH ST SW, EDMONDS WA 98020-3942
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
11 /19/2020
:»•AF9:1H ]1
DATE
Printed: Thursday, November 19, 2020 7:48:19 AM 1 of 2
-KRWOF WAY EUC PERMIT
City of • • •
Ave N, Edmonds WA •:• • 1 1 14.�
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**
E-7 RESTOR LIMITS
Printed: Thursday, November 19, 2020 7:48:19 AM 2 of 2
0 \:L L?,11(7.
"'VC. I S'� J
RECEIVED 11/10/20
ROW PERMIT NO.: ENG 2020-0464
ISSUE DATE: 11/19/20
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: 106371821 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: 9221 217th ST 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) :
Work is approx 14' S to 14' N c/1 of 217th ST SW & 207' W c/1 of 92nd AVE W
(1) 3x5 paving cut & (1) 3x4 paving cut anticipated
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES ❑ NO ❑ Year:
PAVEMENT CUT: D Yes ❑ No If yes, indicate size of cut: 3 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 11/10/2020
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
— - — - — - - — - — - - — - — - - — - — - - — - — _ •.• •-• . • • 4'T • _- — - — - — - — - — - =
�b
LEGEND
® 28" TRAFFIC CONE
® WORK PIT
TRAFFIC FLOW
TtFLAGGER
WORK VEHICLE/
SIGN LO A •ION
RIGHT OF WAY
ROW
SIGN SPACING
MPH
35/40 350'
30 200'
25 100,
0
0
W20-1 �:/ 20-7A
W20-4
W3-4
CHANNELIZATION
r�ri /ir.r�� iG.
V L-V I V L V I ll�1fYL-T
APER
TANGENT
55/70
40
80
35/45
30
60
25/30
20
40
RESIDENT(S) WILL BE INFORMED
OF POSSIBLE TEMPORARY
DRIVEWAY CLOSURE
a �<
PLACE SIGNS
BOTH SIDES OF
WORK AREA
A
217TH ST SW
14
b
14
4
PUGET
SOUND
ENERGY
JOB# 106371821
9221 217TH ST SW, EDMONDS, WA
11 /9/2020
bob.danskin@pse.com
425-398-6168
SHEET 1 of 2
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 14' SCL 217th St SW & 207' WCL
92nd Ave W, 14' NCL 217th St SW & 207' WCL 92nd Ave
W.
9. If used, place NO -PARK signs 72 hours in
advance of the day that the work is to be done.
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 012238
Card Exp. 09/30/2023
gregory.harwood@pse.com
(425)424-6425
RESIDENT(S) WILL BE INFORMED
OF POSSIBLE TEMPORARY
DRIVEWAY CLOSURE
#9221
ROW
TEMPORARY TRAFFIC CONTROL PLAN
W3-4 /
N
O 3
CREW SHALL POTHOLE o
FOR WATER MAIN DEPTH
PRIOR TO PROJECT START D
VL-OZM
V00
�aonn
a
AV oa
]NO
o
0
•
0
0
-----------------------------•-'J-'-='-------=�
SIGN SPACING
MPH
"X"
60/65
1000,
45/55
500'
35/40
350'
30
200'
25
100,
CHANNELIZATION
DEVICE SPACING
MPH
TAPER
TANGENT
55/70
40
80
35/45
30
60
25/30
20
40
14
b
PUGET
SOUND
ENERGY
JOB# 106371821
9221 217TH ST SW, EDMONDS, WA
11 /9/2020
bob.danskin@pse.com
425-398-6168
SHEET 2 of 2
Q
Q
z
N
- Q
ti
W3-4
14 o N
4 0
ONELANE O
ROAD
Notes:
p AHEAD
1. All signs and spacing to conform to the MUTCD
WORK N
and City of Edmonds standards.
AHEAD 3:2.
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. or area will be 14' SCL 217th St SW & 207' WCL
92nd Ave W, 14' NCL 217th St SW & 207' WCL 92nd Ave
W.
9. If used, place NO -PARK signs 72 hours in
advance of the day that the work is to be done.
Job #:
Date:
Jurisdiction:
ROW Permit:
Est. Start Date:
Est. Duration:
106371821
11 /5/20
EDMONDS
Yes
1 /18/20
1 Day (8 Hours)
Puget Sound Energy Gas Pre -Inspect Form
Address: 9221 217th St SW
City / zip: Edmonds, 98020
Customer: Joel Meyer 206.799.7370
PM / Inspector: kevin Williams 425-691-7573
Job Description / Scope of Work
From 2" PE main run new complete 1-1/8 service to SFH(44' scat stub with 40' scat ext) Set 250
New Construction:
meter OR @ Inches
No
Construction Method
All Scat / Trenchless
PLAT Map:
164.067
3/4" STW-U
1960
9229
922',
9215
9207
250 1 1 /9' MID
2019-E
:/g' PE
1991
1-118" PE
W
217th ST SW
a
ROW
60'
-
-
--------
-•-•-•-•-•-•-•-•-•-•-
-•-•-•-•-•-•-•------------------
CL
CD
LA
7' MPE I P 14 5
---1�%���Q��-------
water
Sewer
C14
N
Work
Location
Size of Cut
Surface Type
14'
S
of CL
217th ST SW
&
207'
W
of CL
92nd AVE W
3x5
Asphalt
14'
N
of CL
217th ST SW
&
207'
W
of CL
92nd AVE W
3x4
Asphalt
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 #:
MDPE - 2" IPS - (DIA) 1"CTS
Meter Loc:
0
Trolley Lines:
Mtr Hoods #:
Del Press:
6" W.C.
Traffic Signal:
Bus Stop:
Bollards:
2.5" #
4" #
ADA Ramps #:
Route #'s: