The URL can be used to link to this page

ENG2021-0382 ROW PERMITRIGHT OF WAY EUC PERMIT PERMITNUMBER, City of Edmonds 1 1 ' www.cityofedmonds.gov Description: PSE-EMERGENCY GAS LEAK REPAIR WITH ONLY SOFT SURFACE CUTS ISSUED: 10/07/2021 Address: 8025 192ND ST SW EDMONDS WA 98026-6230 EXPIRES: 04/07/2022 Permit Type: RIGHT OF WAY EUC Permit Subtype: MINOR Parcel Number: 00481600600800 Isle]' 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 WALLACE ROBERT BRUCE III 8025 192ND ST SW, EDMONDS WA 98026 FEE INFORMATION DESCRIPTION AMOUNT PAID CITY TECHNOLOGY FEE CHARGED PER PERMIT $40.00 $0.00 RIGHT OF WAY MINOR - EUC PERMIT FEE $110.00 $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. THIS DOCUMENT IS NOT VALID UNTIL FEES ARE PAID AND THE CITY ENGINEER OR HIS/HER DEPUTY HAS SIGNED BELOW 9— -) �/ �� 10/07/2021 RELEASED BY DATE Printed: Thursday, October 07, 2021 1:08:29 PM 1 of 2 -KRWOF WAY EUC PERMIT City of • • • Edmonds•:• •ENG2021-038 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: Thursday, October 07, 2021 1:08:29 PM 2 of 2 ENG2021-0382 of EpM04O� SECTION A RECEIVED RIGHT OF WAY CONSTRUCTION PERMIT APPLICATION SEP 22 2021 Complete and submit this Application in accordance with the Submittal. CITY OF EDMONDS Requirements outlined in Right-of-Wgy 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. General • Project Name 3001644822 Site Address or if no site address use Property Address at NW corner of project area: 8025 192nd 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? ffOther, please specify: Emergency gas leak repair ❑ 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.) Emergency gas leak repair follow up at approx 25' S c/I of 192nd ST SW & 17' E c/I of 81 st AVE (1) 3x6 grass cu 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 work completed 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? Details of Worl,, 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: o9/22/2o2i 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 RECEIVED rwFRGENICY P ANP TION FORM SEP 22 2021 0-0 3001644822 Address: � V j� CITY DEVELOPMENT MONDS Job #: City / zip: t4o`Nj=6S , 98026 SERVICES DEPARTMENT Date: — j .2d1 Customer: Jurisdiction: E D M O N D S PM / Insp• CUSTOMER PHONE NUMBER P O E BE Work Description 0,1-12 r "l � 9( �VJc-, •z 140 9 Construction Method Open Trench Trenchless ❑ PLAT: 161.069 LEAK #NO134165 KETCH I n SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM OWNER/CONTRACTOR RESPONSIBLE FOR LOCATING ALL ON SITE UTILITIES. RELOCATION/REVISION TO ANY OWNER/CONTRACTOR IS RESPONSIBLE FOR UTILITIES MAY REQUIRE A SEPERATE PERMIT. EROSION CONTROL AND DRAINAGE Utility patches shall be combined and full width or half width overlay will be required depending on the extent Applicant shall repair/replace all patches fall entire) within damage to utilities or frontage of disturbance. Where utility p Y improvements in City right-of-way one travel lane, the overlay shall extend to the per city standards that is caused or centerline of roadway. Where utility patches extend into occurs during the permitted project. both travel lanes then a full width overlay is required. Work Location Size of Cut Surface Type j,C!N(Dof CL �C �� . &,171 W of CL Sty XPC 'NSofCL & 'EWofCL 'N S of CL �& 'E W of CL -31 Notes: 1. All signs and spacing to conform to the MUTCD and City of Lacey 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 17' ECL of 81 st Ave W @ 25' SCL of 192nd St SW. TEMPORARY TRAFFIC CONTROL PLAN PLACE SIGNS BOTH SIDES OF 8025 192nd St SW WORK AREA • t-ow Edmonds o 0 VL-OZM , Z00 wow 6-OZM WA 98026 $n no .� ��¢ Q0w �3= USA �., 100, 100, 100, '� L r► H j I-IE LEGEND ® 28" TRAFFIC CONE ® WORK PIT TRAFFIC FLOW FLAGGER WORK VEHICLE/ FLASHING LIGHTS SIGN LOCATION RIGHT OF WAY -ROW- SIGN SPACING MPH "XI. 60/65 1000, 45/55 500' 35/40 350' 30 200' 25 100' 192ND ST SW }oefoid pa} vied ay; bump sin000 ,s�jsai i i n � uels Alp aad �yt spas � �(�;lO ul s auiaanoad ie� ; a6ewep s tueolldd CHAN DEVI E MPH T PBR TA-NG�1� 55/70 35/45 30 60 Si25/30 20 40 a L--------------- - ,rw ❑pq [� Puget Sound Energy Traffic Control Supervisor: SOUND Kaitlynn Davis Gregory Hawood Card No. 012238 ENERGY 209-456-0264 Card Ex. gregory. harwood@pse.com .pham od@p3 kaitlynn.davis@pse.com a- __-642e 24 Project Address: 8025 192nd St SW, Lacey, WA RECEIVED SEP 22 2021 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT REV 09/21 /2021 0 Job # 300164482 1 OF 1 RECEIVED SEP 22 2021 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT 9314321 / 19207 19215 5/8" PE 990 S 19200 s64� 3 11/4"MPE IP34'R e bad 9805837 No electric grid information available S 160068, Q 161069 09-16-2021 The information on the aHached maps is subject to change without notice. Puget Sound Energy makes no wartanty, expressed or implletl, concerning the suit,bifty of this informafionforany pure e. Recipient,gree tonotdsclose this confidential Information to an other person or entity, unless aulhorizetl In writing by Puget Sountl Energy. This map Is not to be used for determining the actoal location of any PSE facilities Icall '.Al 1)." 19223 19227 199 PE 1991 5/8" PE 1990 1 1 /4" PE IP 14'N 912106 r60'N w 3 N N (V (�V II 19110 1 1/8"MPEI 2014-E 5/8" 5/8" MPE 2009-E 19118 il 19126 3 ST SW 21'N w DEACT 2"MPE 17S 109037473-2007 2" MPE IP 24'S 20'S TT 5/8"MPEI ________= .J�66'S 2010-E 189'N 5/8"MPEI'i O88N 18'N 2009E n/1�N � 8006 a P 3 N �O N N 54' 19231 5/8" MPE 7'S 2009-E 19214 5/8" MPE 2008-E Scale 1:900 Lat\Long=47.8252,-122.3426 OO 7927 MPE 7928 1 1 /8" MPE 2013-E 1920 PE 7925 ® PUG€TSOUND ENERGY