ENG2021-0124 ROW PERMITOF WAY
EUC PERMIT
PERMITNUMBER,
City of
Edmonds
EdmondsRIGHT
98020
1 1
www.cityofedmonds.gov
Description: PSE-INSTALL GAS SERVICE TO MULTI -FAMILY BUILDING
ISSUED: 04/12/2021
Address: 21222 82ND PL W EDMONDS WA 98020
EXPIRES: 10/12/2021
Permit Type: RIGHT OF WAY EUC Permit Subtype: MINOR
Parcel Number: 00467400000600
Isle]
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
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
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
a 04/12/2021
RELEASED BY tl DATE
Printed: Monday, April 12, 2021 12:53:48 PM 1 of 2
-KRWOF WAY EUC PERMIT
City of • • •
•:• •ENG2021-012
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.
INSPECTION TYPE
DATE
RESULT
NOTES
COMPLETE
A-1 JOB START
X-2 ENGINEERING FINAL"
E-7 RESTOR LIMITS
Printed: Monday, April 12, 2021 12:53:48 PM 2 of 2
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 04/07/2021
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
TEMPORARY TRAFFIC CONTROL PLAN
PSE TO COMPLETE WORK PRIOR TO CITY 2021
OVERLAY PROJECT WHICH IS EXPECTED TO
BEGIN IN JUNE 2021.
------------------------------------------------------------------------------------------------------------350'-
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350' 1,
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21222
ENGINEERING DIVISION
APPROVED AS NOTED
04/09/2021
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.
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PUGET
� SOUND
ENERGY
JOB# 106376354
21222 82nd PI W, Edmonds, WA
April - 07 - 2021
ina.ustemchuk@pse.com
(425)398-6063
1--OZM SHEET 1 of 1
-----------------------------------------------------
212TH ST SW
RESIDENT(S) WILL BE INFORMED
OF POSSIBLE TEMPORARY
DRIVEWAY CLOSURE
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PLACE SIGNS
BOTH SIDES OF
WORK AREA
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OWNER/CONTRACTOR IS RESPONSIBLE FOR I o
EROSION CONTROL AND DRAINAGE
LEGEND
®
28" TRAFFIC CONE
®
WORK PIT
I>
TRAFFIC FLOW
TfFLAGGER
WORK VEHICLE/
FLASHING LIGHTS
SIGN LOCATION
RIGHT OF WAY
ROW
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
W3-4
ONE LANE CD
C'
ROAD
AHEAD
ROAD
WORK RECEIVED
N
4HEAD
Apr 07 2021
CITY OF EDMONDS
DEVELOPMENT SERVICES
DEPARTMENT
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 14' WCL of 82nd PI W & 235' SCL
of 212th St SW.
Job #:
Date:
Jurisdiction:
ROW Permit:
Est. Start Date:
Est. Duration:
106376354
1 /6/21
Edmonds
Yes
5/24/21
112 Day (4 Hours)
Puget Sound Energy Gas Pre -Inspect Form
Address:
21222 82ND PL W
City / Zip: Edmonds, 98026
Customer: Gary klick 206-730-0670
PM / Inspector: kevin Williams 425-691-7573
Job Description / Scope of Work
From 1-1/4 PE in 2" casing run new 1-1/4 PE stub to Multi -Family building 21' scat stub and
New Construction:
Yes
post mark for future extension. Edmonds
Paving Row 82nd PL W.
Construction Method
All Scat / Trenchless
PLAT Map: 164.069
212th
ST SW
3/4" STW-U
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8226
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112S
-
5/8" PEI
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,
1982 ----
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21214
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,
1989
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21222
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4 Unit
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residential
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MAINTAIN 5' HORIZONTAL SEPARATION
-=
FROM STORM CULVERT IN FRONT OF
SOUTH -ADJOINING PROPERTY.
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Work
Location
Size of Cut
Surface Type
14'
W
of CL
82nd PL W
&
235'
S
of CL
212th ST SW
3x5
Soft
of CL
&
of CL
of CL
&
of CL
Service Information
Street Information
Job Type
Diameter:
1-1/4" PE
Flaggers #:
No
Arterial:
New Residential Svc
EFV:
1-1/4" - 2600 - 9996744
Police #:
TCP:
Yes
Tie -In Fitting
Meter:
Speed Limit:
25
No Parks #:
Meter Loc:
0
Trolley Lines:
Mtr Hoods #:
Del Press:
Traffic Signal:
Bus Stop:
0
Bollards:
2.5" #
1
1 4" #
I
ADA Ramps #:
Route #'s:
RECEIVED
Apr 07 2021
CITY OF EDMONDS
DEVELOPMENT SERVICES
DEPARTMENT