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ENG2021-0372 ROW PERMITOF WAY EUC PERMIT PERMIT NUMBER City of Edmonds EdmondsRIGHT 121 98020 1 1 www.cityofedmonds.gov Description: PSE-INSTALL GAS SERVICE ISSUED: 10/04/2021 Address: 315 8TH AVE N EDMONDS WA 98020-3412 EXPIRES: 04/04/2022 it Type: RIGHT OF WAY EUC Permit Subtype: MINOR Parcel Number: 00434208501600 w I 11-1411 a 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 MILLS NANCY SUSAN/SORENSON 315 8TH AVE N, EDMONDS WA 98020 LAURIE M INFORMFEE DESCRIPTION AMOUNT PAID CITY TECHNOLOGY FEE CHARGED PER PERMIT $40.00 $0.00 RIGHT OF WAY MINOR - EUC PERMIT FEE $110.00 $0.00 THIS DOCUMENT IS NOT VALID UNTIL FEES ARE PAID AND THE CITY ENGINEER OR HIS/HER DEPUTY HAS SIGNED BELOW 10/04/2021 RELEASED BY // DATE Printed: Monday, October 04, 2021 2:01:10 PM 1 of 2 -KRWOF WAY EUC PERMIT City of • • • •:• •ENG2021-037 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 7:00am to 6:00pm on SOUND OR NOISE weekdays and 10:00am and 6:00pm 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: Monday, October 04, 2021 2:01:10 PM 2 of 2 ENG2021-0372 of EDM0 4os RECEIVED RIGHT OF WAY CONSTRUCTION PERMIT APPLICATION SEP 15 2021 Complete and submit this Application in accordance with the Submittal CITY OF EDMONDS /'Vc. i sa° Requirements outlined in Right -of -Way permit Handout E6�. DEVELOPMENT q � X-p 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 1o63798o9 Site Address or if no site address use Property Address at NW corner of project area: 315 8th AVE N 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 x 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.) Install gas service at approx 15' S c/l of Sprague St & 54o'E c/l of 7th AVE N (1) 3x5 soft surface 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 Ix I LF SF i day 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 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 project is proposed: x 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: 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: 09/15/2021 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 SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM RECEIVED SEP 15 2021 Job #: Date: Jurisdiction: ROW Permit: Est. Start Date: Est. Duration: Puget Sound Energy Gas Pre -Inspect Form Address: City of Edmonds City / Zip: Edmonds, 98020 Yes Customer: Donnie Little / Susan Dut 425-750-0486 9/27/21 PM / Inspector: Logan Ghiringhelli 1 (804) 401-6809 1 Day (8 Hours) 106379809 7/28/21 315 8TH AVE N CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT Job Description ROW Scope of Work Project Scope: From 2" PE main (87 3087) on Sprague St - install approx 70' (20' Stub with 2600 EFV & 50' extension) of 1-1/8" PE scat New Construction: No svc ext and set an A630 meter at inches, Rear center. ROW 60'. Construction Method All Scat / Trenchless PLAT Map: 162.067 OWNER/CONTRACTOR IS RESPONSIBLE FOR EROSION CONTROL AND DRAINAGE N 1 5/6, PE 5/6'PE 1992 1 J 1991 O 13 1 811 V � = Sprague St ' Sewer J JIT- z water _ 2" PE IP i 5S Tree Tree 4 - 738 U 315 304 - - =E D rivaway Utility shall be combined and full width or half OWNER/CONTRACTOR RESPONSIBLE FOR LOCATING patches p ALL ON SITE UTILITIES. RELOCATION/REVISION TO ANY - - width overlay will be required depending on the extent UTILITIES MAY REQUIRE A SEPERATE PERMIT. of disturbance. Where utility patches fall entirely within one travel lane, the overlay shall extend to the l centerline of roadway. Where utility patches extend into ENGINEERING DIVISION Applicant shall repair/replace all both travel lanes then a full Width Overlay is required. damage to utilities or frontage APPROVED AS NOTED improvements in City right-of-way 739 74 74� per city standards that is caused or occurs during the permitted project. ^%l/ U/Q�,,7�,44z 10/04/2021 VV 1 300 i ., Work Location Size of Cut Surface Type 15' South of CL Sprague St & 540' East of CL 7th Ave N 3 x 5 Soft Surface of CL & of CL of CL & of CL of CL & of CL Service Information Street Information Job Type Diameter: 1-1/8" PE Flaggers #: Arterial: No New Residential Svc EFV: 1-1/8" - 2600 - 9999144 Police #: TCP: Yes Tie -In Fitting Meter: A630 I I I Speed Limit: No Parks #: HDPE - 2" IPS - (DIA) 1"CTS 9999564 Meter Loc: Rear Center Trolley Lines: Mtr Hoods #: Del Press: 6" W.C. Traffic Signal: Bus Stop: SNO YRD -Snohomish ' Bollards: 2.5" # 1 1 4" # ADA Ramps #: Route #'s: 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 for 315 8TH AVE N, will be at 15' South of centerline of SPRAGUE ST, and at 540' East of centerline of 7TH AVE N. TEMPORARY TRAFFIC CONTROL PLAN USE MAXIMUM AVAILABLE SPACE FOR SIGNS y SPRAGUE ST m • z X, X1 _;U � 0o o� 0 D W21-7 W5-1 LEGEND ® 28" TRAFFIC CONE ® WORK PIT TRAFFIC FLOW FLAGGER 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 10C X' CV �• • • • � CV CHANNELIZATION DEVICE SPACING MPH TAPER TANGENT 55/70 40 80 35/45 30 60 25/30 20 40 L- 2m 115 8th Ave N Edmonds WA 98020 USA RECEIVED SEP 15 2021 CITY OF EDMONDS DEVELOPMENT 6 ZOZ3,0/0 ISERVICES DEPARTMENT 4310N SV GDAO Jdd`d N01�� `rf'Ib��NI�N� Puget Sound Energy REV PUGETI Traffic Control Supervisor: SOUND MATLOCK HIGHBARGER CaedNo 012238 08/26/2021 0 Card No. 012238 ENERGY 808-375-4152 Card Ex .pham od@p3 Job # gregory.phamood@pse.com MATLOCK.HIGH BARGER@PSE.COM (425(424-64106379809 Project Address: 315 8TH AVE N, EDMONDS, WA Page 1 OF 1 c1t 740 7d .. 754 75e 798 a4a bla m 84 6" a50 MA ^ 716 730 750 ". aos 711 7;5 72' -9 727 739 747 757 -.. .�. - $21 as 837 843 a55 t _ — dx - ». all 8c9 .� S RAG E ST 722 ? J UNKNOWN 7i0 72S E52 &56 316 Z LLl 7m NO N 729 U KNO VN Q — 733 739 7G1 745 y 300 all all ay UNKNOWN UNKNOWN J 311 _ !— — 751, U (NO N ONDS ST Z7&6 220 7 c 728 750' 220 810 6,8 R C aao • 'm 221 Z. ov I SIP 15 I+YT f I 73' 'b$f W 8 5 DEVE OPMENT _ SERVICES DEPARTMENT Q 3'c 747 56 2W - = I $25 84 BELL ST ELL S 5/8'PE 1991 5/8' PE 1992 ST a s 2" PE IP 15S J 6,p 0 8 7308 7 / F a 5/8'PE 1987 W.T.-*, 739 1 741 304 5/8'PE 1991 CITY OF EDMONDS DEVELOPMENT RVICES DEPARTME 811 J 745