ENG2021-0236 APPROVED ROW PERMIT REVISION 1OF WAY EUC PERMIT
PERMIT NUMBER
City of Edmonds
EdmondsRIGHT
98020 1 1
www.cityofedmonds.gov
Description: PSE-NEW COMMERCIAL SERVICE (REVISION 1) ISSUED: 07/20/2021
Address: 22931 HIGHWAY 99 EDMONDS WA 98026-8468
EXPIRES: 01/20/2022
it Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 00576700000205
I 11-14111 a i
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
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE CHARGED PER PERMIT $40.00 $0.00
ENGINEERING INSPECTION FEE $220.00 $0.00
ENGINEERING REVISION REVIEW FEE $110.00 $0.00
RIGHT OF WAY STANDARD - EUC PERMIT FEE $330.00 $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.
RELEASED BY
THIS DOCUMENT IS NOT VALID UNTIL FEES ARE PAID AND THE CITY ENGINEER OR HIS/HER DEPUTY HAS SIGNED BELOW
DATE
08/30/2021 (Revision 1
Permit originally issued 7/20/21 w/ expiry date of 1/20/21. Revision 1 (to expand the size of the tie-in hole) issued 8/30/21. No change to initial expiry date.
Printed: Monday, August 30, 20219:26:48 AM 1 of 2
-KRWOF WAY EUC PERMIT
ER
City of • • •
•:• •ENG2021-0236
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 RESTOR LIMITS
E-7 CONCRETE SIDEWALK
E-7 CURB GUTTER
Printed: Monday, August 30, 2021 9:26:48 AM 2 of 2
of EDMO"os RECEIVED
RIGHT OF WAY CONSTRUCTION
PERMIT APPLICATION Jun 28 2021
CITY OF EDMONDS
DEVELOPMENT SERVICES
Complete and submit this Application in accordance with the Submittal DEPARTMENT
/'Vc. is') 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 1o6378634
Site Address or if no site address use Property Address at NW corner of project area: 22931 Highway 99
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 ixCommercial ❑ 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
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.)
From 2" STW main run new complete 1-1/4 commercial service (36' scat stub with 20' scat ext.) Also C&C 5/8 PE
left at nroverty line back to main.
Work area is approx 12' S to 1' S c/l and 11' N c/l of 23oth ST SW & 22o' E c/1 of Highway 99 (1) 3x5 concrete/
asphalt cut anticipated (1) 2xri paving cut & (1) 3x , paving cut 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 day 8 hrs
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 ixgas
❑ 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 existing underground common utility stem?
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? I I 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:
[
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:
[
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: 6XVDQ6LGLFN DATE:
APPLICANT PRINTED NAME: 6XVDQ6LGLFN
APPLICANT TITLE: 653HUPLW6SHFLDOLVW
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021
� b \
TEMPORARY TRAFFIC CONTROL PLAN
- SCHEDULE ALL INSPECTION THROUGH MYBUILDINGPERMIT.COM
- SCHEDULE FINAL INSPECTION WHEN WORK IS COMPLETE
- IF SIDEWALK CUTS ARE MADE, A RESTORATION LIMITS INSPECTION
AND ADDITIONAL INSPECTION FEE WILL BE ADDED TO THE PERMIT.
RESIDENT(S) WILL BE INFORMED
OF POSSIBLE TEMPORARY
DRIVEWAY CLOSURE
RECEIVING PIT
--_-__-__�w�--___- R-W__--_RIB-�
maintain 2) 1' lanes W a W
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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 12' SCL of 230th St SW &
220' ECL of Highway 99
LEGEND
®
28" TRAFFIC CONE
®
WORK PIT
TRAFFIC FLOW
WORK VEHICLE/
FLASHING LIGHTS
SIGN LOCATION
RIGHT OF WAY
Row
X' —ekW ----
6-OZM
inn,
�_�----------------- � 2
ROW-ROWROW-ROW-ROW-------------_I-----
--------------230TH ST SW -----------------
USE MAXIMUM AVAILABLE
SPACE FOR SIGNS
11NW 13d 31`d 13d3S `d 32flnC)321 A VIAI S3iiriiin
AN`d Ol NOISIA3&NOIl`d00I321 'S311nin 311S NO 7171`d
ONIiVOO-1 ?J03 3719ISNOdS3] J 2:]O-LOV�J1N00RJ3NMO
30VNI`d 10 GNV-1102J1N00 NOISO213
210d 3-I81SNOdS32 SI 2J01 V J1N00/2i3NMO
SIGN SPACING
MPH
"X"
60/65
1000,
45/55
500'
35/40
350'
30
200'
25
100'
CHANP
DEVIC
EWa��cTKKied aq
8RACWG3e41 spi
MPH
TA
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55/70
A.0
Ile
aoelda$Dadai II
35/45
0
25/30
20
40 11
buunp sir
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F�C�N S'Ff�1 %1�5�dd`d
ENERGY 425-424-6425
Kali-Jamal.Collins@pse.com
"ect Address:
22931 Highway 99, Edmonds, WA
s301Aa3s
121111YA
C13AI
REV
06/18/2021 0
Job #
106378364
1 OF 2
W20-1
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 12' SCL of 230th St SW &
220' ECL of Highway 99
TEMPORARY TRAFFIC CONTROL PLAN
,
,
:' 7, p
`_________-R8W------- ROWROW R /-R&*
,
LEGEND
®
28" TRAFFIC CONE
®
WORK PIT
TRAFFIC FLOW
WORK VEHICLE/
FLASHING LIGHTS
SIGN LOCATION
RIGHT OF WAY
Row
RESIDENT(S) WILL BE INFORMED
OF POSSIBLE TEMPORARY
DRIVEWAY CLOSURE
CREW SHALL POTHOLE
FOR WATER MAIN DEPTH
PRIOR TO PROJECT START
P�EM
•
•
n w R = 00 maintain (2) 11' lanes
o lx
SIGN SPACING
MPH
"XI.
60/65
1000,
45/55
500'
35/40
350'
30
200'
25
100'
21a5- � ZM
]b-6M wo 6-OZM
it
100' Wl
100'
W 100,
[*
- — - — - — -
— -
— -
— a
b
—ROWROWROW=ROW—ROW— _____________________________ _________________________ _ _ _ _ _____ L ____________
230TH ST SW
CHANNELIZATION
DEVICE SPACING
MPH
TAPER
TANGENT
55/70
40
80
35/45
30
60
25/30
20
40
DesiPUGETgner: S30IAH3 �ht}�F��P4mor. REV
SOUND Kali-Jamal Collins SON wa�'�d 06/18/2021 0
Card No. 012238
ENERGY 425-424-6425 ZO 9� ham�pse.com Job #
Kali-Jamal.Collins@pse.com Q (425)424-6425 106378364
Project Address:
22931 Highway 99, Edmonds, WA Page 2 OF 2
REVISION
Job #:
Date:
Jurisdiction:
ROW Permit:
Est. Start Date:
Est. Duration:
106378364
6/11 /21
EDMONDS
Yes
8/23/21
1 Day (8 Hours)
Puget Sound Energy Gas Pre -Inspect Form
AUG 12 2021
OF
Address: 22931 HIGHWAY 99 CITY DEVELOPMEENTS
City / Zip: Edmonds, 98026 SERVIC=EPARTMENT
Customer: Billy w/Blue Hope CO 253-223-3636
PM / Inspector: kevin Williams 425-691-7573
Job Description / Scope of Work
From 2" STW main run new complete 1-1/4 commercial service (36' scat stub with 20' scat ext.)
New Construction:
set 425 meter
at marked location, @ 2PS1. Also C&C 5/8
PE left at property line back to main.
No
Construction Method
All Scat / Trenchless
PLAT Map:
166.069
t
N
�Q-
(�
22931
425 2-PSI
Inches
1-114" PE
�ON
w
�
0
Storm
Water
— — 230TH ST SW
� w
N
ROW 60' CL — ' UtII Cab? _—= w
T
2" STW IP 12'S
2" STW IP 12'S o
12 5,��
8488-1966
13
84�6�
s
I�
4' P L
Work
Location
Size of Cut
Surface Type
12'
Q
of CL
230th ST SW
&
220'
E
of CL
HIGHWAY 99
3x5
oncrete/Asphal
1'
S
of CL
230th ST SW
&
220'
E
of CL
HIGHWAY 99
2x5
Asphalt
11'
N
of CL
230th ST SW
&
220'
E
of CL
HIGHWAY 99
3x5
Asphalt
Service Information
Street Information
Job Type
Diameter:
1-1/4" PE
Flaggers #:
Yes
Arterial:
No
New Commercial Svc
EFV:
1-1/4" - 2600 - 9996744
Police #:
No
TCP:
Yes
Tie -In Fitting
Meter:
A425
I
I
I
Speed Limit:
25
No Parks #:
Yes
Meter Loc:
02 - OFL
Trolley Lines:
Mtr Hoods #:
Del Press:
2 PSI
Traffic Signal:
Bus Stop:
Bollards:
2.5" #
4" #
ADA Ramps #:
Route #'s:
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.
ENGINEERING DIVISION
APPROVED AS NOTED
1p]/ W1,10,,44z 08/27/2021
Machuga, Jen
From: Williams, Kevin <Kevin.Williams@pse.com> REVISION
Sent: Thursday, August 12, 2021 3:09 PM
To: Edmonds Engineering Permits
Cc: Sidick, Susan AUG 12 2021
Subject: FW: 106378364
Attachments: 106378364 _ Harvest Wonton Noodle _ Prelns p p ect. df; Permit. p df CITY DEVELOPMENT
ELOPPMMENDS
ENT
SERVICES DEPARTMENT
Categories: Green category
Hello,
Our service provider thinks our tie-in hole to connect gas will need to be a 3x12 hole mostly in sidewalk to install anodes
for the steel main 12'-14' S CL.
They would like to confirm they have permission to cut additional SQ FT for our tie in hole. No other change in scope
other than larger hole.
Thank you!
Kevin Williams
Project Manager
Customer & System Projects - Bothell
C: 425-691-7573
E: Kevin.Williams@pse.com
20000 north creek PKWY
Bothell, WA 98011
www.pse.com
-----Original Message -----
From: Nichols, David <David.Nichols@ infrasourceinc.com>
Sent: Thursday, August 12, 2021 2:09 PM
To: Williams, Kevin <Kevin.WiIlia ms@pse.com>
Cc: Holmes, Aaron <Aaron.Holmes@infrasourceinc.com>; Burns, Aurelie <aurelie.burns@pse.com>; Jensen, Keri -
InfraSource Construction <Keri.Jensen@pse.com>; Lima, David <david.lima@pse.com>; Hamilton, David - InfraSource
Construction <David.Hamilton@pse.com>
Subject: 106378364
CAUTION - EXTERNAL EMAILPhishing? Click the PhishAlarm "Report Phish" button.For mobile - forward to
abuse@pse.com
Hi Kevin, we will need a 3x12 cut permitted at tie in to install 2 anodes.
Thank you
Sent from my iPhone
1
RECEIVED
Jun 28 2021
CITY OF EDMONDS
DEVELOPMENT SERVICES
DEPARTMENT
i