ENG2020-0490 ROW PERMITRIGHT OF WAY EUC PERMIT
PERMITNUMBER,
City of Edmonds
-0490
_7 121 5th Ave N, Edmonds WA 98020 ENG2020 )i
www.cityofedmonds.gov
Description: PSE-INSTALL GAS SERVICE ISSUED: 12/29/2020
Address: 1125 9TH AVE S EDMONDS WA 98020-3963
EXPIRES: 06/29/2021
it Type: RIGHT OF WAY EUC Permit Subtype: MINOR Parcel Number: 27032500111400
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 KEOUGH JAMES R 1125 9TH AVE S, EDMONDS WA 98020-3963
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE CHARGED PER PERMIT
$40.00 $0.00
ENGINEERING INSPECTION FEE
$220.00 $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
J. MaJ-L.� 12/29/2020
RELEASED BY DATE
Printed: Tuesday, December 29, 2020 10:52:05 AM 1 of 2
-KRWOF WAY EUC PERMIT
City of • • •
Ave•:• • 1 1 14'1
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.
It is the owner's responsibility to repair/replace all damage of utilities or frontage improvements in
DAMAGE TO FRONTAGE
City right of Ways or Easements to City Standards caused by or occurring during the permitted
IMPROVEMENTS
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 REQ
Maintain erosion and sedimentation control per City and SWMMW standard requirements.
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 any and all claims for damages of whatever nature, arising directly or indirectly from the
HOLD HARMLESS
issuance for 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 and 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.
All utilities shall be located prior to any excavation. New locates shall be called for if at time of
UTILITY LOCATES
excavation, original locates are no longer identifiable.
INSPECTIONS
INSPECTION TYPE
DATE
RESULT
COMPLETE
X-2 ENGINEERING FINAL"
E-7 TRAFFIC CTRL
E-7 RESTOR LIMITS
Printed: Tuesday, December 29, 2020 10:52:05 AM 2 of 2
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PROJECT NAME:
CONTRACTOR:
RECEIVED 12/8/20
ROW PERMIT NO.: ENG 2020-0490
ISSUE DATE: 12/29/20
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
106372966 CONTACT: Susan Sidick
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: 1125 9 AVE S
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 24' W to 5' E to 20' E c/l of 9th Ave S & 228' N c/1 of Sea Vista PI
(1) 3x5 concrete cut (1) 2x6 paving & (1) 2x4 concrete / grass cut anticipated
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES ❑ NO ❑ Year:
PAVEMENT CUT: ❑x 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
Contractor or Agent
DATE
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
TEMPORARY TRAFFIC CONTROL PLAN
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PLACE SIGN AT CORNER aa3Hs�aD
OF PINE ST & 9TH AVE S a3S0° �;dM3as
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PLACE SIGNS ON
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Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 012238
Card Exp. 09/30/2023
gregory.harwood@pse.com
(425)424-6425
LEGEND
f
28" TRAFFIC CONE
®
WORK PIT
TRAFFIC FLOW
WORK VEHICLE/
FLASHING LIGHTS
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SIGN LOCATION
RIGHT OF WAY
ROW
co
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ni 1IaoM �C
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N
SEA VISTA PL
W p
PINE ST
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22,22
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IDEWALK CLOSED
ASCROOSS S HERE
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END p
ROAD WORK
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PUGET
SOUND
ENERGY
JOB# 106372966
1125 9TH AVE S, EDMONDS, WA 98020
REV-1, 12/28/2020
jason.bisenius@pse.com
425-424-7316
SHEET 1 of 3
ENGINEERING DIVISION
APPROVED AS NOTED
9IQ
12/29/2020
MAINTAIN TWO 11' TRAVEL a i
LANES AT ALL TIMES.
OWNER/CONTRACTOR IS RESPONSIBLE FOR
EROSION CONTROL AND DRAINAGE
maintain (2) 1 T lanes
1125
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.
l-OZM
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SEA VISTA PL
IN
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100
------------------------
j 220TH ST SW
IN
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ROAD
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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 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 24' WCL of 9th Ave S & 228' NCL
of Sea Vista PL.
SIGN SPACING
MPH
IXI
60/65
1000,
45/55
500'
35/40
350'
30
200'
25
110'
CHANNELIZATION
DEVICE SPACING
MPH
TAPER
TANGENT
55/70
40
80
35/45
30
60
25/30
20
40
RESUB
DEC 28 2020
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
maintain (2) 11' lanes
TEMPORARY TRAFFIC CONTROL PLAN
SEA VISTA PL
�a
3a3° PLACE SIGN AT CORNER
a3so �� dM3a OF PINE ST & 9TH AVE S
[:: -- -�- '- - - �-- - " L- -
22SEA VISTA PL
P� 2:
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1
10
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z
;IV
i0
220TH ST SW
PUGET
SOUND
ENERGY
JOB# 106372966
1125 9TH AVE S, EDMONDS, WA 98020
REV-1, 12/28/2020
jason.bisenius@pse.com
425-424-7316
SHEET 2 of 3
9 9
11' TRAVEL
IMES. ,
Q
14 1 14
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 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 24' WCL of 9th Ave S & 228' NCL
of Sea Vista PL.
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
Job #:
Date:
Jurisdiction:
ROW Permit:
Est. Start Date:
Est. Duration:
Puget Sound Energy Gas Pre -Inspect Form
106372966
11 /25/20
EDMONDS
Yes
2/1 /21
1-112 Days (12 hours)
Address:
City / Zip:
Customer:
PM / Inspector:
1125 9TH AVE S
EDMONDS, 98020
REBEKAH ALLEN 425-205-9515
Kevin Williams 425-691-7573
Job Description / Scope of Work
From 2" PE main run new complete 1-1/8 PE service to SFH (52' scat stub with 70' scat ext.) Set
New Construction:
250 meter OR
@ Inches
No
Construction Method
All Scat / Trenchless
PLAT Map:
164.067
5/8" PE
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1994
N
M
'— CL
1123
ROW ! 60'
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Drivaway
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31' N
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23
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C14
CL _ -
LLJ e0 n �
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5/8" ARE
901
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1997
C4
Work
Location
Size of Cut
Surface Type
24'
W
of CL
9th AVE S
&
228'
N
of CL
Sea Vista PL
3x5
Concrete
5'
E
of CL
9th AVE S
&
228'
N
of CL
Sea Vista PL
2x6
Asphalt
20'
E
of CL
9th AVE S
&
228'
N
of CL
Sea Vista PL
2x4
Concrete/grass
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
I
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Speed Limit:
25
No Parks #:
MDPE - 2" IPS - (DIA) 1"CTS
Meter Loc:
107048105-2014
Trolley Lines:
Mtr Hoods #:
Del Press:
6" W.C.
Traffic Signal:
Bus Stop:
Bollards:
2.5" #
1
1 4" #
ADA Ramps #:
Route #'s: