ENG2021-0207 ROW PERMITOF WAY EUC PERMIT
PERMIT NUMBER
City of Edmonds
AveRIGHT
9801 1 1
www.cityofedmonds.gov
Description: PSE-YEARLY VALVE MAINTENANCE AT 4 SITES ISSUED: 06/17/2021
Address: 10000-10016 EDMONDS WAY EDMONDS WA 98020
EXPIRES: 12/14/2021
rmit Type: RIGHT OF WAY EUC Permit Subtype: MINOR Parcel Number: 00610700200803
I 11-1411 a
i
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 WESTGATE VILLAGE LLC 4025 DELRIDGE WAY SW STE 350, SEATTLE WA 98106
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.
iffl, U/.
RELEASE13tY
THIS DOCUMENT IS NOT VALID UNTIL FEES ARE PAID AND THE CITY ENGINEER OR HIS/HER DEPUTY HAS SIGNED BELOW
6/17/2021
DATE
Printed: Thursday, June 17, 2021 9:53:29 AM 1 of 2
-KRWOF WAY EUC PERMIT
PERMIT NUMBER
City of • • •
Ave•:• • 1 1 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.
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.
TRAFFIC CONTROL
Traffic Control per approved plan and MUTCD. All Flaggers shall be certified.
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
X-2 ENGINEERING FINAL"
E-7 TRAFFIC CTRL
Printed: Thursday, June 17, 2021 9:53:29 AM 2 of 2
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TRAFFIC BARRELS
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TRAFFIC FLOW
WORK VEHICLE
SIGN LOCATION
WARNING FLAG
ARROW BOARD
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Notification No. 1719901
u Notes:
1. All signs and spacing to conform to the MUTCD
PUGET
SOUND
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\/ and City of Edmonds standards. Job#87400012
2. All sidewalks, driveways, exits and egresses shall be Edmonds Way & 100th Ave W, Edmonds, WA
completely clear unless otherwise indicated. September 26, 201 E
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3. Channelizing devices are 28" traffic cones. Sheet 1 of 3 gregory.harwood@pse.corr
sue° 4. Sign size can be a minimum of 48" x 48" and shall not (425) 424-642E
obstruct pedestrian access.
5. Crew is required to leave a minimum of 11' for traveling
lane width.
6. Alert affected residents and businesses.
USE STEADY TRAFFIC \ \ \ 7. Work to take place between 9 a.m. and �p.m. 3 PM
BARRELS WITH BEACONS \ \ Q 8. Work area will be 20' SCL of Edmonds Way
at 560' WCL
of 100th Ave W.
9. If used, place NO -PARK signs 72 hours in advance
'�ti"• \ \ of the day that the work is to be done.
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APPROVED WORK HOURS: M-F 9 AM TO 3 PM
SATURDAYS 10 AM TO 6 PM
SIDEWALK CLOSURE NOT a o�
PERMITTED WITH THIS PERMIT
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MINIMUM TAPER LENGTH = L (feet)
i
LANE
POSTED SPEED LIMITS
WIDTHS
20
25
30
35
40
45
10
70
105
150
205
295
475
11
75
115
165
225
295
495
12
1 80
1 125
1 180
1 245
320
1 540
CHANNELIZATION
DEVICE SPACING
TANGENT
TAPER
MPH
80
40
55/70
60
30
35/45
40
20
25/30
SIGN SPACING
"X"
55 +
800
60/65
500'
45/55
350'
35/40
200'
30
100,
25
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SIDEWALK CLOSURE NOT PERMITTED
WITH THIS PERMIT
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WORK VEHICLE
SIGN LOCATION
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Notification Numbers 1719905 & 1719906
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.
4. Sign size can be a minimum of 48" x 48" 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. andxp.m. 3 PM
8. Work areas will be 19' & 28' WCL of 100th Ave W at 21'
NCL of Edmonds Way.
9. If used, place NO -PARK signs 72 hours in advance
of the day that the work is to be done.
*CONTACT WSDOT AUTHORITIES 48 TO 72 HOURS
IN ADVANCE OF WORK ON EDMONDS WAY/SR-104.
CONTACT BONIE NAU (206) 440-4471
*CITY OF EDMONDS POLICE OFFICER RQUIRED.
*TO REQUEST AN OFFICER, CONTACT JASON
SHIER AT (206) 353-2967 A MINIMUM OF 7 DAYS
PRIOR TO START OF WORK (SEE ATTACHED
INFORMATION).
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Job#87400012
Edmonds Way & 100th Ave W, Edmonds, WA
September 26, 201 E
Sheet 2 of 3 gregory.harwood@pse.corr
(425) 424-642E
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EDMONDS WAY (SR 104)
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SIGN SPACING
55 +
"X"
60/65
800
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
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EDMONDS
MINIMUM TAPER LENGTH = L (feet)
LANE
POSTED SPEED LIMITS
WIDTHS
20
25
30
35
40
45
10
70
105
150
205
295
475
11
75
115
165
225
295
495
12
80
125
180
245
320
540
SIDEWALK CLOSURE NOT PERMITTED WITH THIS
PERMIT
X'
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W20-1
LEGEND
.
TRAFFIC BARRELS
WITH BEACONS
®
BORE PIT
TRAFFIC FLOW
FLAGGER
WORK VEHICLE
SIGN LOCATION
WARNING FLAG
0 ARROW BOARD
Notification No. 1719900
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PUGET
' SOUND
ENERGI
Job#87400012
Edmonds Way & 100th Ave W, Edmonds, WA
September 26, 201 E
Sheet 3 of 3 gregory.harwood@pse.corr
(425) 424-642F
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.
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EDMONDS WAY (S
MINIMUM TAPER LENGTH = L (feet)
LANE
POSTED SPEED LIMITS
WIDTHS
--
207
25
30
35
40
45
10
70
105
150
205
295
475
11
75
115
165
225
295
495
12
80
125
180
245
320
540
CHANNELIZATION
DEVICE SPACING
TANGENT
TAPER
MPH
80
40
55/70
60
30
35/45
40
20
25/30
97TH AVE SW \
I
SIGN SPACING
"X"
55 +
800
60/65
500'
45/55
350'
35/40
200'
30
100,
25
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.
4. Sign size can be a minimum of 48" x 48" 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.
8. Work area will be 23' NCL of Edmonds Way at 24' WCL
of 98th Ave W (Esm't)
9. If used, place NO -PARK signs 72 hours in advance
of the day that the work is to be done.
OFF DUTY DETAIL INFORMATION SHEET
EDMONDS POLICE OFFICERS ASSOCIATION
250 5T" AVE N, EDMONDS, WA 98020
The purpose of this sheet is to provide information regarding the requesting of; cost of; and
procedures for scheduling Police Officers for'off-duty' details within the City of Edmonds.
Point of Contact:
• Officer Jason Shier, EPOA Vice President:
o Email: vicepresident.epoa@gmai1.com.
o Cellular phone: 206-353-2987
Requesting an officer: (Please request an officer with as much advance notice as possible!)
• To schedule an officer, please email Officer Jason Shier at
vicepresident.epoa@gmail.com. Please include your company name, Point of Contact
(name, phone number, and email), location of the detail, date(s) and time(s) of detail,
and a brief description of what officer will be doing (i.e. directing traffic, closing a traffic
lane, providing security, etc).
• Additionally, if your Point of Contact is NOT the same person to whom the invoice is to
be sent, please include the 'Finance Person's': name, email address, and phone
number.
NOTE: Oficer Shier works a rotating schedule, so to insure that your detail request is
received and reviewed in a timely manner, it is recommended that you call his cell phone
in addition to sendina the email.
Rate of Pay: (NOTE: Minimum of 4 hours will be paid to the officer)
• Requests made 7 or more days in advance: The rate of pay for an officer working an off -
duty detail will be $75 per hour.
• Requests made less than 7 days in advance: The rate of pay for an officer working and
off -duty detail will be $80 per hour.
1
Effective: May 24, 2018
OFF DUTY DETAIL INFORMATION SHEET
• Details that fall on a holiday will be paid at an additional $30 per hour ($105 per hour
with 7 or more days notice/$110 per hour if less than 7 days notice).
List of Holidays:
New Year's Day (January 1)
Washington's Birthday (Third Monday of February)
Independence Day (July 4)
Veteran's Day (November 11)
Friday following Thanksgiving Day
Martin Luther King Day (Third Monday of January)
Memorial Day (Last Monday of May)
Labor Day (First Monday of September)
Thanksgiving Day (Fourth Thursday of November)
Christmas Eve (December 24)
Christmas Day (December 25) New Year's Eve (December 31)
Cancellations: (Note: date and time of cancellation will be based on the date and time of the
phone call, not email.)
• To cancel an officer, you MUST call Officer Shier at 206-353-2987. Additionally, please
follow up the phone call with an email to vicepresident.epoa@gmaii.com requesting
the cancellation If you cancel an officer more than 24 hours before the start of the
detail, you will not be charged for the cancelled detail.
• If you cancel an officer less than 12 hours prior to the start of the detail, you will be
charged for the '4 hour minimum'.
• Administrative fees will still be charged for all details, regardless of when they are
cancelled.
Payment Deadlines:
• If you do not require an invoice, officers are to be paid via check or cash at the start of
the event. (check made payable directly to the individual officer(s).
• If you require an invoice, officers should be paid within two weeks of invoice being
emailed to your Point of Contact (or Finance if provided).
• Delays in paying officers may result in difficulty obtaining officers for future details.
2
Effective: May 24, 2018
of EpMp�O�
ENG2021-0207
RIGHT OF WAY CONSTRUCTION
PERMIT APPLICATION RECEIVED
1
Complete and submit this Application in accordance with the Submittal Jun 08 202
CITY OF EDM NDS
02
/'Vc. i sa° Requirements outlined in Right -of -Way permit Handout E6�. DEVELOPMENT SERVICES
DEPARTMENT
If any field is not applicable to your project, write "N/A' instead of leaving blank.
All fields required. Incomplete Applications will be denied.
SECTION A
General •
Project Name 8987033545 - valve inspection
Site Address or if no site address use Property Address at NW corner of project area: w000-1oo16 Edmonds Way
Associated Permits: BLD PLN ENG X
Owner and Entity Holding Franchise (if applicable)
Name of Company PSE/Infrasource Franchise Ordinance No:
Point of Contact Susan Sid ick
Title SR Permit Specialist
Address 1660 Park lane
city Burlington
State WA
Zip 98233
Phone 425-457-6353
Email susan.sidickapse.com
Contractor and Authorized Agent of Owner
Name of Company
(see note below)
Contractor Contacts During Construction
Primary Name PSE/Infrasource Susan Sidick
Agent Name PSE/Infrasource
Title SR Permit Specialist
Title SR Permit Specialist
Mobile 425-457-6353
Address 1660 Park lane
Email susan.sidick@pse.com
City Burlington
State WA
Zip 98233
Secondary Name
Phone 425-457-6353
Title SR Permit Specialist
Email susan.sidick@pse.com
Mobile
City of Edmonds Business License No:
Email
State License No: INFRASL871 C2
[N Contractor verifies it is currently bonded
E* Contractor verifies it currently has general liability insurance
NOTE: ECDC 18.6o. o2o requires that the Application be signed by a licensed and bonded contractor unless otherwise approved by the city
engineer.
❑ Multifamily residential ❑ Commercial ❑ City project
❑ Single family residential subdivision ❑ Single family -other ❑ Industrial
❑ Demo and rebuild or from vacant land?
L3xOther, please specify: yearly valve inspection
❑ Utility Franchise Work associated with development (check one of the above boxes as welt
❑ Traffic Control Only (no associated development)
❑ Utility Franchise Work (no associated development)
City of Edmonds ROW construction permit Application --Page 1 of 3 Updated 3/25/2021
Include an overall narrative description of the proposed work. Be specific and detailed:
Describe infrastructure to be impacted, such as, poles, wires, conduit, utility mains, etc.
Include whether this is construction, maintenance, or repair.
Include description of proposed construction methods, (e.g., bores, trenches, overhead wires proposed, depth for
underground utilities, etc.)
Yearly valve inspection perform yearly corrosion inspections at 4 locations on Edmonds Way.
No paving cuts, anticipated
RIGHT-OF-WAY
CLOSURE
AREA
TOTAL
DURATION
(Number of Months)
Sidewalk 72 hours +
LF
I x
LF
SF
Alley 72 hours +
LF
Ix
I LF
SF
Parking 72 hours +
LF
I x
I LF
SF
1 minutes er location
SECTION B - If you are not a utility company performing work in the City ROW, skip to SECTIONC.
1. The work in the right of way is on or for the following type of facilities:
❑ telecommunications ❑ cable ❑ power ii,,gas
❑ water ❑ sewer ❑ storm
Details of Work to be Completed
1. Does the utility owner have existing overhead infrastructure in the area of work?
Yes
No
x
2. Will any equipment be added underground or above ground (e.. pedestals, vaults, etc.)?
x
If yes, describe:
3.
Does the proposed work connect a lot or commercial development with utilities that serve more
than one lot or commercial development?
x
4.
Does the work involve rebuilding or relocating an existing aboveground utility system which
connects a lot or commercial development to an existingunderground common utilitystem?
x
5.
Does the work involve proposed additions to an aboveground utility stem? If es:
x
Are the additions for the purpose of serving new commercial development?
x
Are the additions for the purpose of serving a single-family residential subdivision?
x
Details
of Work to be Completed
Yes
No
6.
Does your project involve rebuilding or replacing utility equipment which currently serves more
than one lot or commercial development?
If yes, answer the following questions related to project area, i.e. the actual area in which the
x
project is proposed:
6a.
Does your project involve wires/cables/lines? If yes:
x
How many are existing? How many are to be added?
City of Edmonds ROW construction permit Application --Page 2 of 3 Updated 3/25/2021
6b.
Does your project involve poles? If yes:
x
How many poles are existing in the project area?
What is the height of the existing poles?
How many poles are to be removed?
Are additional poles to be laced?
How many? I I What is the height of the additionalpoles?
6c.
Are any poles to be modified/rebuilt/replaced? If yes:
x
How many? I I What is the height of the poles after?
Describe the modification rebuild:
SECTION C
Traffic Control and Public Safety. 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. Restoration shall 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.
Insurance. The City may require the owner or contractor to provide proof of insurance acceptable to the City prior to
any permit approval.
Indemnification. The Applicant agrees to defend, indemnify, and hold harmless the City of Edmonds, its officials,
officers, employees, and agents against any injuries, damages, or claims of any kind or description whatsoever,
foreseen or unforeseen, including defense costs and attorney fees, resulting directly or indirectly from any act or
omission of the Applicant, its subcontractors, anyone directly or indirectly employed by them, and anyone for whose
acts or omissions they may be liable, arising out of, related to, or by reason of the granting of this permit; and
specifically including but not limited to all loss by the failure of the Applicant to fully or adequately perform, in any
respect, all authorizations or obligations under the permit. These indemnification requirements shall survive the
expiration, revocation, or termination of any resulting permit approval.
Acceptance of terms, conditions, and requirements. Applicant accepts the terms, conditions, and
requirements set forth in this Application and agrees they apply to any resulting permit and shall comply with them to
the satisfaction of the City Engineer. Applicant further agrees to comply with the conditions listed on the Submittal
Requirements; with all applicable city ordinances, including but not limited to ECDC Title 18; and with all applicable
requirements of state and federal law.
Statement of Applicant. I declare under penalty of perjury under the laws of the State of Washington that: I am a
licensed and bonded contractor; the information provided herein is correct and complete; and I am authorized by
owner to act on its behalf and have authority to bind the owner to this application.
Fees. The Applicant is responsible for all permit fees.
APPLICANT SIGNATURE: Susan Sidick
APPLICANT PRINTED NAME: Susan Sidick
APPLICANT TITLE: SR Permit Specialist
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021
2021
R e @T.,j
887033545
PRE -INSPECTION REPORT
Q PUGET SOUND ENERGY
Date: 6/4/21
Jurisdiction: Edmonds
Address: 10000-10016 Edmonds Way
City / Zip:
Right of Way Permit? O YES ❑ No Customer:
Est. Start Date: 08/04/21
Est. Duration: 15 mins at each location
CUST PHONE NUMBER
PM / Insp:
PHONE NUMBER
Construction Method
WORK DESCRIPTION:
Trenchless ❑
Open Trench ❑
Permform yearly inspections at wire box located at 4 locations as shown on this plan
New Construct ❑
Existing
1
_
TS-032991 TS-0S173S
TSO 911
TS-OS1736
23' Ncl Edmonds Way & 24' Wcl 98
560' Wcl 100 Ave W & 20' 21' NO Edmonds Way &
21' Ncl Edmonds Way & Ave W. In right west bound lane of
Scl Edmonds Way. Front of 19' Wcl 100 Ave W
28' Wcl 100 Ave W Edmonds Way. Just South of
McDonalds.
Starbucks
RECEIVED
Jun 08 2021
CITY OF EDMONDS
DEVELOPMENT SERVICES
DEPARTMENT
Work Location
Size of Cut
SurfaceType
'NSofCL &
'EWofCL
'NSofCL &
'EWofCL
'NSofCL &
'EWofCL
❑ FLAGGERS # MPH ❑ TROLLY LINES ❑ BUS STOP # ❑ METER HOODS #
❑ OFFICERS # SPEED LIMIT ❑ TRAFFIC SIGNAL ❑ ARTERIAL ❑ NO PARKS #
❑ Commercial ❑ Altered Commercial ❑ Leak Repair
Service Information ❑ Template Bar
❑ Residential ❑ Altered Residential ❑ CP Work
Diameter Meter EFV Pressure ❑ Bollards 2.5" #
❑ Multi -Family ❑ Replacement Service ❑ Pothole
❑ 5/8" ❑ 250 ❑ 1800 ❑ 6" WC
❑ New Constr. ❑ Main Maintenance ❑ Extension
❑ Bollards 4" #
❑ 11/8" ❑ 425 ❑ 2600 ❑ 2#
❑ Stub ❑ Service Maintenance
❑ 11/4" ❑ 630 ❑ 10,000 ❑ > 5## ❑ FUEL LINE PERMIT NEEDED
❑ Extension ❑ Valve Maintenance
❑ 2" ❑ 1000 Fuel Line Length:
❑ Compete Sery ❑ Cut & Cap Mtr Loc:
Fuel Line Diameter:
Edmonds Way & 100 Ave W / & 98 Ave W & Edmonds Way
Job# 887033545
OT �i'` t�
TS-032991
560' Wcl 100 Ave W & 20'
Scl Edmonds Way. Front of
McDonalds.
eta
ets-.Edm- s �
5-051735
21' Ncl Edmonds Way &
19' Wcl 100 Ave W
Perform yearly inspections at wire box and get read at 4 locations as shown on site
plan.
Duration: 15 mins at each location.
Traffic Plan provided for traffic control. Police & flagger & additional people on
site.
RECEIVED
Jun 08 2021
CITY OF EDMONDS
DEVELOPMENT SERVICES
DEPARTMENT
Date of Request:
Job number:
Job address:
Project mgr:
PM email:
PERMIT REQUEST FORM
06/04/21
887033545
RECEIVED
Jun 08 2021
CITY OF EDMONDS
DEVELOPMENT SERVICES
DEPARTMENT
10000-10016 Edmonds Way City: Edmonds Zip.
Betty Frank
betty.frank@pse.com
Estimated job start date:
08/04/21
Estimated job completion date: 08/04/21
PM contact #. (206) 716-2641
Description of work to be performed:
perform yearly corrosion inspections at 4 locations on Edmonds Way.
Pavement cut? ❑Yes ❑✓ No
If yes, Dimensions of Cut: Length_
How many cuts?
Surface Type hard asphalt
Require trenching? Dyes ❑No
If yes, Dimensions of trench: Length_
Width
Width
Depth
Method of installation:
Traffic impact:
Road closed ❑Yes ❑ No
Lane closed [?]Yes ❑ No How Many? 1 Direction? West
Shoulder closed ❑Yes ❑ No
Sidewalk closed ❑Yes ❑ No
Emergency Contact: Thane sunde Print Send
Cell Number: (206) 437-9170
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