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ENG2021-0264 ROW PERMITOF WAY EUC PERMIT PERMITNUMBER, City of Edmonds EdmondsRIGHT 98020 1 1 www.cityofedmonds.gov Description: PUD-REPLACE BO POLE ISSUED: 08/03/2021 Address: 8427 202ND ST SW EDMONDS WA 98026-6642 EXPIRES: 02/03/2022 Permit Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 27041900207400 iiii I 11-14111 a NAME TYPE NAME ADDRESS PHONE APPLICANT SNOHOMISH COUNTY PUD P.O. BOX 1107, EVERETT WA 98206 (425)670-3216 CONTRACTOR SNOHOMISH COUNTY PUD P.O. BOX 1107, EVERETT WA 98206 (425)670-3216 OWNER MARK AND JENNIFER COONS 8421 202ND ST SW, EDMONDS WA 98026 (425)422-0900 FEE INFORMATION DESCRIPTION AMOUNT PAID CITY TECHNOLOGY FEE CHARGED PER PERMIT $40.00 $0.00 RIGHT OF WAY STANDARD - EUC PERMIT FEE $330.00 $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 08/03/2021 RELEASED BY DATE Printed: Tuesday, August 03, 2021 11:33:58 AM 1 of 2 -KRWOF WAY EUC PERMIT City of • • • •:• •ENG2021-026 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. 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 RESULT INSPECTION MEN A-1 JOB START X-2 ENGINEERING FINAL" Printed: Tuesday, August 03, 2021 11:33:58 AM 2 of 2 ENG2021-0264 OfEDkQ�OJ RECEIVED MGH 1`I` OF �l`�TAiY C01\\ STRUCTff01\\J J U L 15 2021 PERMIT APPLICATION Complete and submit this Application in accordance with the Submittal CITY OF EDMONDS Avc. 1890 Requirements outlined in Ri ht-of-Wa permit Handout Mi. DEVELOPMENT q 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. WO# 100081467 SECTIONA General Info — Project Name Site Address or if no site address use PropertyAddress at NW corner of project area: �421Z Associated Permits: I BLD PLN ENG • • • • Name of Company applicable) Franchise Ordinance No: Point of Contact Title Address City �� State Zip Phone — `z_` b Email �iM a Name of Company Nw� Primary Namev Agent Name Title Title Mobile Address Email City State Zip Secondary Name Phone Title Email Mobile City of Edmonds Business License No: Email State License No: .. 0 — ' Contractor verifies it is currently bonded Contractor verifies it currently has general liability insurance NOTE: ECDC18.6o.o2o requires that the Application be signed by a licensed and bonded contractor unless otherurise 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 welD 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.) (� 1 TOTAL DURATION RIGHT-OF-WAY AREA (Number of Months) CLOSURE Sidewalk 72 hours + LF x LF SF SF Alley 72 hours + LF x LF SF parking 72 hours + LF x LF SECTION B -If you are not a utility company performing work in the City ROW, skip to SECTION C. 1. The work in the right of way is on or for the following type of facilities: : ❑ telecommunications ❑ cable ❑ power ❑ gas ❑ water ❑ sewer ❑ storm 1.I Does the utility owner have existing overhead infrastructure in the area of work? 2. Will any equipment be added underground or above ground (e.. pedestals, vaults) etc.)? 7 If es, describe: Does the proposed work connect a lot or commercial development with utilities that serve more 3. than one lot or commercial development? Does the work involve rebuilding or relocating an existing aboveground utility system which 4. connects a lot or commercial development to an existing underground common utilitys stem? 5. Does the work involve proposed additions to an above ound utili stem? If es: Are the additions for the purpose of serving new commercial development. Are the additions for the purpose of serving a single-famq residential subdivision? n .; ='A.l . . 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 project is proposed: 6a. Does your project involve wires/cables/lines? If yes: How manv 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: r Howmany poles are existing in the project area? What is the height of the existing poles? How many poles are to be removed? Are additional oles to be Place& How man ? What is the height of the additional -poles? 6c. Are any poles to be modified/rebuilt/replaced? If yes: How man ? 1 What is the hei ht of the poles after? Lt5 f Describe the modification rebuild: n 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. ! '7 APPLICANT SIGNATURE: ` 2 _ DATE: oil APPLICANT PRINTED NAME: APPLICANT TITLE: NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE City of Edmonds ROW constructionpermitApplication--Page 3 of 3 Updated 3/25/2021 rAHpucani sndu iepd uieH dGe a i damage to utilities or frontage improvements in City right-of-way per city standards that is caused or occurs during the permitted project. ENGINEERING DIVISION APPROVED AS NOTED 08/02/2021 VV _3Nf1S013 3NdI 7101M =AHMaV N 3Ndl 2 -_ Nb'Id . 1�NIN.03 JIJJV N1 OWNER/CO T..F=.FaQR EROS'IM CONTROLAND•DRAINAGE M—L alS 33S) 331A3a 9NIZI.-I3NNVHO -NO 3N❑O � ,OWN E R/CONTRACTOR RESPONSIBLE FOR L �CATING ALL ON SITE UTILITIES.' 'RELOCATION/REVISI N TO ANY U ILITIES 1 jlJ R UIREASEP.ERATEPEIRMIT. ZV3HH NottonSISN 1N3WdIn03 NO S1VIN31VW ' uvoa . N H1IA 31IS NNOM 3H1 SS333V 01 ® M❑ 13 OI33V211 1df12R131NI Ism i 310N 33S N N❑1OVNIN❑O 3H1 N3A3N3HM 3I.33VN1 0g IONIN03 01 (DNi 103N SN399V-13" 'b 2133NI9N3 3H1 A Q3AO.NddV SV AaVA XVW S33NVISICI E 3Sf1 -3WI1—IHMN N❑3 N9IS HOV3 lV .((M-1V1SN3 �F 39 33VHS N❑OV3g 9NIHSV73 Z I MON 33S c SJIVA(1V❑N _1VJN31NV -NOA 002 a I N 'CHdW Sz) S133E1 3VI1N3QIS321 d❑3 .001 3S 33VHS SN9IS N33A13E 33NV1Sla T [IN CV 3-ISVi) 0 H1911133 2i3dV1 x NOOV3H < > H1IA 81, 9NIHSVI H1IA �IOrral F V38V ANOA 1N3A121Vd34 SdOIAJAS 1N3Ad0'13n34 SONOA43 d0.11l3 �zoz 94 inr a3A13DMI 0 NI NIW ,IT ITT -4. Str OtIS 0S17 Sig. 07 02E OLz 0b SE O_bZ OOZ OE 08I 0SI ESE OE SZ OP-1 00? SZ C13) N3dV1 !)NO -IV 9NIOVdS 3N❑3 ,2T* 10I (HdW) '133dS HICIIA 13S JO C13) HI9N3-1 a3dV1 V 3-19VI •(V 313V1) H19N3-1 N3dV1 131ON 33S 131❑N 33S or " SAONNVN OV❑N (I —Ozer) aV3HV NouanNiSNO ❑Voa Google Maps Page 1 of 1 Goc gle Maps Cancel Imagery ©2021 Maxar Technologies, U.S. 50 ft Geological Survey, Map data ©2021 Print RECEIVED JUL 15 2021 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT https://www.google.comlmaps/placel8427+202nd+St+S W/@47.8163131,-122.3480018,12... 7/ 14/2021 °Oo PUBLIC UTILITY DISTRICT NO.1 OF SNOHOMISH COUNTY LOCATION 8427 202ND ST SW ED LYNNAREA POLE NO. 9567 NW1/4S 19 T 27 R 04 DATE 7/2/21 ORDER 100081467 REASON FOR WORK REPLACE BO POLE FOR PUD ENGINEER MCALLISTER OPERATION 30 DRAFTER U.G. NO. SCALE APPROVED & DATE PRINTED DATE WORK COMPLETED FOREMAN FEES REQ'D ❑ YES ■ NO PRIMARY OVERHEAD ❑ RESIDENTIAL ❑ COMMERCIAL LEO NO. I@$ '=$ SECONDARY OVERHEAD BASIC FEE S METER/CONV.POLE s PRIMARY UNDERGROUND ❑ RESIDENTIAL ❑ COMMERCIAL BASIC FEE S LEU NO. I@$ SECONDARY UNDERGROUND BASIC FEE $ NESC VIOLATIONS ■ NO ❑ YES (SEE NOTES) PERMITS (DATE GRANTED) ❑ TREE TRIM ❑ STATE ❑ COUNTY ■ CITY EASEMENTS ❑ REQUIRED 0 NOT REQUIRED I@$ I=$ UAIL KLLLASLU UNDERGROUND PLAT FOREIGN CONTACTS BASIC FEE $ ■ JPN# Q FT.@Y _$ ❑ JOINT TRENCH ZIPLY & CATV STREET LIGHTING ❑ JOINT BORE ZIPLY & CATV WORK IN RIGHT OF WAY POLE STENCILING ❑ PRIMARY FROM TO ❑ SECONDARY TAKE OFF POLE Q FT.@$ _$ PRE-CONST. REQUIRMENTS MISCELLANEOUS FEES ❑ TREE TRIM ❑ PUD LOCATOR ❑ BACKHOE ❑ FLAGGING VAULT $ ■ ONE CALL DATE PERMIT $ No. 80 POLE $ STREET LIGHTING $ ■ YES ❑ NO S M&R AS -BUILT S GIS TOTAL DUE $ DATE PAID GIS QC M&R RECEIPT NO. GIS Ph JOINT USE SERVICE ORDER NO. LOCATION MAP PAGE 455 J5 LEGEND: O EXISTING POLE X EXISTING POLE -TO BE REMOVED • NEW POLE NEW POLE TO REPLACE EXISTING POLE DATE SUBSTATION MPL CIRCUIT NO. 346 PHASE 1 ENGR'S TEL. # 425-670-3216 ENGR'S CELL # 425-501-1254 RECEIVED JUL 15 2021 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT POLE 9567 REPLACE BO 45'POLE SET NEW POLE TIGHT W OF EXITNG POLE AND FRAME PER ASSY 12V101, AND 12V601 XFR [11 PRI AND [I] NEUT TO NEW POLE XFR DIST XFMR 25-21044 SEC VOLT / XFR S.L. #128468 STRIP AND TOP OLD POLE m 421 3 U) t- U) Z< NN N� C r` N- oo I it rv� WL JF E: