ENG2021-0033 ROW PERMITRIGHT OF WAY EUC PERMIT
PERMITNUMBER,
City of Edmonds
• ••� 1 1111
www.cityofedmonds.gov
Description: PSE-INSTALL GAS SERVICE ISSUED: 02/08/2021
Address: 615 WALNUT ST EDMONDS WA 98020-3421
EXPIRES: 08/09/2021
it Type: RIGHT OF WAY EUC Permit Subtype: MINOR Parcel Number: 00434209403500
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 EVANS WILLIAM B & YVONNE E 615 WALNUT ST, EDMONDS WA 98020-3421
LIVING TRUST
INFORMFEE
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.
77 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
02/08/2021
RELEASED BY
DATE
Printed: Monday, February 08, 2021 1:07:50 PM 1 of 2
-KRWOF WAY EUC PERMIT
City of • • •
Ave•:• •ENG2021-0033
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
A-1 JOB START
E-7 RESTOR LIMITS
X-2 ENGINEERING FINAL"
Printed: Monday, February 08, 2021 1:07:50 PM 2 of 2
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"VC. I S'� J
RECEIVED
JAN 26 2021
ROW PERMIT NO.: ENG 2021-0033
CITY OF EDMONDS ISSUE DATE: 2/8/2021
DEVELOPMENT
SERVICES DEPARTMENT
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: 106374099 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: 615 Walnut ST
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 annrox 21' s TO In TO 13' n c/l of Walnut St & 143' F c/1 of 6th AVE S
(1) 5x6 paving cut (1) 2x2 paving and (1) 3x5 paving 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 DATE 01/26/2021
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 012238
Card Exp. 09/30/2023
gregory.harwood@pse.com
(425)424-6425 p
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PLACE SIGNS
BOTH SIDES OF
WORK AREA
0,
TO
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
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TEMPORARY TRAFFIC CONTROL PLAN
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WALNUT ST
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PUT UP PARKING CLOSURE
SIGNS AS NECESSARY TO
KEEP TRAVEL LANE OPEN
RESIDENT(S) WILL BE INFORMED
OF POSSIBLE TEMPORARY
DRIVEWAY CLOSURE
PUGET
� SOUND
ENERGY
JOB# 106374099
615 WALNUT ST, EDMONDS
REV1 - 01/28/2021
FLAVIANA. N UN ES@PSE.COM
425-424-7809
SHEET 1 of 2
18 _LM] I.
Wiz♦ a ~ m A 2 4 I► 100 I►
`100
in
- - maintain (2) 11' lanes
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uniess atmerwise Specified. All ow r arterials -
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East of CL 6th Ave S.
9. If used, place NO -PARK signs 72 hours in
advance of the day that the work is to be done.
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n
WALNUT ST
CHANNELIZATION
DEVICE SPACING
MPH
TAPER
TANGENT
55/70
40
80
35/45
30
60
25/30
20
40
� o
00 -
G20-2
NEAREST ADJACENT ST
CROSSABLE CORNER
OR CROSSWALK
LEGEND
®
28" TRAFFIC CONE
®
WORK PIT
TRAFFIC FLOW
WORK VEHICLE/
FLASHING LIGHTS
SIGN LOCATION
RIGHT OF WAY
ROW
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 012238
Card Exp. 09/30/2023
gregory.harwood@pse.com
(425)424-6425 p
A."A.a"
zQp,l
a oat,
of
PLACE SIGNS
BOTH SIDES OF
WORK AREA
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 3' North of CL Walnut St & 143' East
of CL 6th Ave S and 13' North of CL Walnut St & 143' East
of CL 6th Ave S.
9. If used, place NO -PARK signs 72 hours in
advance of the day that the work is to be done.
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
RESUB
JAN 29 2021
Job #:
Date:
Jurisdiction:
ROW Permit:
Est. Start Date:
Est. Duration:
106374099
1 /20/21
EDMONDS
Yes
3/29/21
1 Day (8 Hours)
Puget Sound Energy Gas Pre -Inspect Form
Address:
City / Zip:
Customer:
PM / Inspector:
CITY OF EDMONDS
DEVELOPMENT
615 WALNUT ST SERVICES DEPARTMENT
EDMONDS, 98020
SUZANNE BULLOCK 503-789-0012
kevin Williams 425-691-7573
Job Description / Scope of Work
From 6" STW main run new complete service to SFH(50' scat stub with 25' scat ext.) Set 250
New Construction:
meter OL @ Inches
No
Construction Method
Maintain 10' separation from water
valves because of block support
All Scat / Trenchless
PLAT Map: 163.066
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2003
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2003
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621
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0
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I
5/8" PE
CV —
425
603
I
1991
I
36'
1-118" PE
I
Fire Hydrant
--———————
—— — — — — —— --
110' Min Seporation
I
—I Water
_
S2
—4-------0-- sewer
,19'$----------------
I
12 E 19'S Row 60'
6" STW IP 21 S I
12E,2I'S
I ' Walnut ST
2187-19 1
o
------+,+� —
--
00
M(h
— — — —— — ---- --
— —— Storm
14
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5 /R" P F
Work
Location
Size of Cut
Surface Type
21'
S
of CL
Walnut ST
&
143'
E
of CL
6th AVE S
5x6
Asphalt
3'
N
of CL
Walnut ST
&
143'
E
of CL
6th AVE S
2x2
Asphalt
13'
N
of CL
Walnut ST
&
143'
E
of CL
6th AVE S
3x5
Asphalt
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:
25
No Parks #:
Yes
Meter Loc:
03 - OL
Trolley Lines:
Mtr Hoods #:
Del Press:
6" W.C.
Traffic Signal:
I
Bus Stop:
I0
Bollards:
2.5" #
4" #
I ADA Ramps #:1
Route #'s: