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ENG2021-0374 ROW PERMITOF WAY EUC PERMIT PERMIT NUMBER City of Edmonds EdmondsRIGHT 98020 1 1 � www.cityofedmonds.gov Description: OVWSD-INSTALL TWO NEW 1"WATER SERVICES ISSUED: 09/27/2021 Address: 721 EDMONDS WAY EDMONDS WA 98020-5125 EXPIRES: 03/28/2022 it Type: RIGHT OF WAY EUC Permit Subtype: MINOR Parcel Number: 00745300000500 I 1111-14111 a W NAME TYPE NAME ADDRESS PHONE APPLICANT OLYMPIC VIEW WATER & SEWER EDMONDS WA 98026 (425)774-7769 DISTRICT CONTRACTOR OLYMPIC VIEW WATER & SEWER EDMONDS WA 98026 (425)774-7769 DISTRICT OWNER CHUNG SUI H & LAI S/CHUNG 18321 3RD AVE SW, SHORELINE WA 98177 STEPHEN 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. RELEASED BY THIS DOCUMENT IS NOT VALID UNTIL FEES ARE PAID AND THE CITY ENGINEER OR HIS/HER DEPUTY HAS SIGNED BELOW DATE Printed: Monday, September 27, 2021 7:24:09 AM 1 of 2 -KRWOF WAY EUC PERMIT PERMIT NUMBER 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: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: Monday, September 27, 2021 7:24:09 AM 2 of 2 ENG2021-0374 pF E U ltON �o� 1 RIGHT OF WAY CONSTRUCTION PERMIT APPLICATION fka Complete and submit this Application in accordance with the Submittal ONC, l s91, Requirements outlined in Right -of -Way permit Handout E63. If any field is not applicable to your project, write """A=913teaving blank. All fields required. Incomplete Applications wf111wdt-fltAed. �ZOZ 9� daS SECTION Q3 `I333U Project Name ­72 t �'A�& ,�14 �,1 G fy Site Address or if no side address use Property Addr NIV corner of project area: a . Associated Permits: BLD PIN ENG I Owner and Entity Holding Franchise (if applicable) Name of Company ` 6.� ; i1, Franchise Ordinance No: Point of Contact �^ 2� N LytleJF&rcyn Address 812_2btici -o - City GN 1,10 I d S IState '�Zip980-Z Phone y -7 - 7--? Email M • Name of Company O Primary Name �- Agent NameC lytle�� Mobile ( 193 - %qlo ` Lytle Address 1 2z t Email L.(-er. Cch" City State Zip Cl U -L Secondary Name b Phone Cy 7? .�� 'Lytle rL�J1li Sd✓� Email arY 6 Mobile qVi) 530 City of Edmonds Bu mess License No: L'tnaH State License No: ❑ Contractor verifies it is currently bonded ❑ Contractor verifies it currently has general liability insurance ATOT H. ECDCj8.6o.o2o requires that the Application be signed by a licensed and bonded contractor unless otherwise approved by the city engineer. &. a, . Development — Check ALL that apply ❑ Multifamily residential ❑ Commercial ❑ City project ❑ Single family residential subdivision ❑ Single family -other ❑ Industrial o Demo and rebuild or from vacant land? ❑ Other, please specify: Utility Franchise Work associated with development (check one of the above boxes as well) ❑ 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 atr 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.) RIGHT-OF-WAY CLOSURE AREA TOTAL DURATION (Number of Months) Sidewalk 72 hours + LF x LF SF Alley 72 hours + LF x LF SF Parking 72 hours + LF x LF SF SECTION B - If your are not a utility compare performing work in the City ROY1; ski-p to SECTIONC. i. The work in the right of way is on or for the following type of facilities:: ❑ telecommunications In cable In power ❑ gas )(-Nvater ❑ sewer In storm s • . • • 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.)? If yes, describe: " �;Gtcr meA bzzaS 3. Does the proposed work co nett a lot or co inertial development with utilities that serve more than one lot or commercial development? 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 above round utility stem? If es: Are the additions for the purpose of serving new commercial development? Are the additions for the purpose of serving a single-family residential subdivision? X 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: How many are existing? i I How manv are to be added? ( l ° :: I City of Edmonds ROW constniction permit Application --Page 2 of 3 Updated 3/25/2021 66. 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 imny poles are to be removed? Are additional poles to be laced? How many? What is the height of the additional poles? : ::........:..:.:..::;...:::::.:: 6c. Are any poles to be modified/rebuilt/replaced? If yes: How many? 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 296-155-3o5 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. � l APPLICANT SIGNATURE: - DATE: (��-' � Z APPLICANT PRINTED NAME: APPLICANTTITLE: NO WORK SHALL BEGIRT PRIOR TO PERMIT ISSUANCE City of Edinotids ROW construction permit Application --Page 3 of 3 Updated 3/25/2021 RECEIVED Sep 16 2021 CITY OF EDMONDS DEVELOPMENT SERVICES OLYMPIC VIEW WATER & SEWER DISTRICT DEPARTMENT EDMONDS BLANKET PERMIT BEGINNING NOTIFICATION Site Address: 721 Edmonds Way Scope of Work: Install (2) new water services Asphalt or Concrete Cut: Yes Start date: 9/22/2021 Olympic View Water & Sewer District 8128 228th ST SW Edmonds WA. 98026 Phone Number 425 774 7769 Fax Number 425 670 1856 Contact: Marty Henninger E-mail: marty@ovwater.com Olympic View Water & Sewer District 8128 228th ST SW Edmonds WA. 98026 Phone Number 425 774 7769 Fax Number 425 670 1856 Contact: Dave Barnes E-mail: Daveb@ovwater.com • Traffic control shall be in accordance with the MUTCD. • All flaggers shall be trained and certified as required by WAC 296-155-305. • Restoration shall be in accordance with City of Edmonds standards. • All asphalt or concrete cut surfaces shall be patched with City of Edmonds approved materials prior to the end of the day. O:\SHARE\PERMITS RIGHT OF WAYS\Edmonds rrr I OF ED NDS-- ` \ D MAENT NRVICES 6096 c 9096 /� Oz606 9292z i 66� 180-91 ���i 62 9z2 Ez9zz / 0,,1 11-66-9LG\p 60606 P ooz - bz�909, ENGINEERING DIVISION - -I — -- -- - -Z9 I APPROVED AS NOTED ( I I-- -;--: -- � �': � � H Mae�692'z - 09/27/2021 ^�°�y \�ti 1 , — -- — — —� — -- 1 00/1 1 96606 1 66606 I 6E606 908 �� i i� " 0. I �� I I I W �? Vzz —Z8 Applicant shall repair/replace all / \ ., 9096 _ S' 90992,909zz pp damage to utilities or frontage \ 6096 _ ! � t' �sn g g � 2'096 _. -- 06� O � improvements in City right-of-way ti vi \ o =A�ze 1� 9 per city standards that is caused or ®°DOG'C~ \ �9 ®—Z8 ©oo.o m \` y m occurs during the permitted project. � ti.: "" � ;' �i \ 0z� , t t—za it bzl, 9 �. L00Z-9Z l50gall bL6-1S1a IW 1LL Y I n' F�o 1 608 I �08 I 6E66 "' o� ® �N$� D O �J® LLI / �- Q. d®�� ®�,� ®�®ps 099 I dE606 140-9011 66506 666 \� OWNER/CONTRACTOR IS RESPONSIBLE FOR i 668 \ 908 I 9E66 G6,G OWNER/CONTRACTOR RESPONSIBLE FOR LOCATING A—/ I s\ \ I ALL ON SITE UTILITIES. 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