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ENG2021-0224 ROW PERMITOF WAY EUC PERMIT PERMIT NUMBER City of Edmonds EdmondsRIGHT 98020 1 1 � www.cityofedmonds.gov Description: PSE REPLACE TEST LEAD WIRES IN SOFT SURFACE ISSUED: 07/06/2021 Address: 8328 200TH ST SW EDMONDS WA 98026-6735 EXPIRES: 01/06/2022 rmit Type: RIGHT OF WAY EUC Permit Subtype: MINOR Parcel Number: 00431200000102 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 CRAIG ROSS D & PAYTE STACY G 1033 EDMONDS ST, EDMONDS WA 98020-2905 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 07/06/2021 :»•>/F9:1H ]1 DATE Printed: Tuesday, July 06, 2021 9:17:40 AM 1 of 2 -KRWOF WAY EUC PERMIT ER City of • • • •:• •ENG2021-022 www.cityofedmonds.gov• • 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. 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: Tuesday, July 06, 2021 9:17:40 AM 2 of 2 of EpM04O� RIGHT OF WAY CONSTRUCTION PERMIT APPLICATION Complete and submit this Application in accordance with the Submittal /'Vc. i sa° Requirements outlined in Right -of -Way permit Handout E6�. 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 109137759 Site Address or if no site address use Property Address at NW corner of project area: 8328 tooth ST SW 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 d( 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? ❑ Other, please specify: ❑ 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 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 DATE: o6/23/2021 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 TEMPORARY TRAFFIC CONTROL PLAN SCHEDULE ALL INSPECTION THROUGH MYBUILDINGPERMIT.COM 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 Work area will be 20' SCL of 200th St SW & 130' WCL of 83rd PI W. If used, place NO -PARK signs 72 hours in advance of the day that the work is to be done. ------------ KEEP SIDEWALK OPEN O m 0 I• U • O a I � M 00 8328 200th St SW Edmonds WA 98026 USA FT KEEP DRIVEWAY OPEN 1,-OM ofw O � Q I - ¢ I • ti n N -' 0110 0 3: �IQry W3-4 RIGHT LANE L9 -' CLOSED N o AHEAD ROAD WORK o AHEAD TRAFFIC CONTROL INSPECTION REQUIRED OWNER/CONTRACTOR RESPONSIBLE FOR LOCATING ALL ON SITE UTILITIES. RELOCATION/REVISION TO ANY UTILITIES MAY REQUIRE A SEPERATE PERMIT. OWNER/CONTRACTOR IS RESPONSIBLE FOR EROSION CONTROL AND DRAINAGE 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. SIGN SPACING MPH "x" 60/65 1000, 45/55 500' 35/40 350' 30 200' 25 100' ENGINEERING DIVISION APPROVED AS NOTED JX U J,1,4zo7/06/2021 VV 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 WORK VEHICLE/ FLASHING LIGHTS SIGN LOCATION RIGHT OF WAY ROW - Puget Sound Energy REV PUGET Designer: Traffic Control Supervisor: Gregory Harwood 06/19/2021 0 SOUND PATRICK MCGHUEY Card No.012238 09/30/2023 Job # ENERGY (360) 570-6801 Card ry.h mood@ps g regory, ha rwood@pse. com patrick.mcghuey@pse.com (425)424-6425 109137759 Project Address: 8328 200TH ST SW, EDMONDS Page 1 OF 1