ENG2021-0405 ROW PERMITRIGHT OF WAY EUC PERMIT
PERMIT NUMBER
City of Edmonds
-0405
www.cityofedmonds.gov
Description: PUD-REPAIR EXIST T-MOBILE ANTENNA SITE ON TRANSMISSION POLE ISSUED: 10/18/2021
Address: 8317 188TH ST SW EDMONDS WA 98026-6025
EXPIRES: 04/18/2022
rmit Type: RIGHT OF WAY EUC Permit Subtype: MINOR Parcel Number: 00567500002300
i
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 ROMBAKH REAL ESTATE LLC 15949 104TH AVE NE, BOTHELL WA 98011
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE CHARGED PER PERMIT
$40.00 $0.00
ENGINEERING INSPECTION FEE
$110.00 $0.00
RIGHT OF WAY MINOR - EUC PERMIT FEE
$110.00 $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
10/18/2021
:»•>/F9:1H ]1
DATE
Printed: Monday, October 18, 2021 2:43:07 PM 1 of 2
-KRWOF WAY EUC PERMIT
PERMITNUMBER,
City of Edmonds
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 7:00am 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
INSPECTION TYPE
DATE
RESULT
COMPLETE
A-1 JOB START
X-2 ENGINEERING FINAL"
E-7 TRAFFIC CTRL
Printed: Monday, October 18, 2021 2:43:07 PM 2 of 2
WO# 100085922
ofEOMotio� RECEIVED
RIGHT OF WAY CONSTRUCTION OCT 15 2021
PERMIT APPLICATION
Complete and submit this Application in accordance with the Submittal CITY OF EDMONDS
/'V . i?ao a Requirements outlined in Right -of -Way permit Handout E6�. 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.
SECTION A
General •
Project Name T-MOBILE PERRINVILLE - SE01553 -REPAIR "URGENT"
Site Address or if no site address use Property Address at NW corner of project area: 8317 188th St SW Edmonds, WA
Associated Permits: BLD PLN ENG
Owner and Entity Holding Franchise (if applicable)
Name of Company Snohomish County PUD NO.1 Franchise Ordinance No:
Point of Contact Aziz Haq
Title Engineer
Address P.O. Box 1107
City Everett
State WA
Zip 98206
Phone 425-783-5251
Email Jointuse@snopud.com // MahaQ@snopud.com
Contractor and Authorized Agent of Owner
Name of Company same info as above
(see note below)
Contractor Contacts During Construction
Primary Name same info as above
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: 313-005-741
U Contractor verifies it is currently bonded
® 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?
❑ Other, please specify:
❑ Utility Franchise Work associated with development (check one of the above boxes as welt
R 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.)
This work includes troubleshooting and repairing the existing T-Mobile antenna site located on the steel
transmisison pole near the listed address. Work should take 1-long day to complete. The equipment setup will require a road closure due to the
large equipment required to access the pole top. Refer to ENG2021-0071for similar road closure request for same pole location.
If weekend work is preferred to minimize impact, work can be completed on the weekend.
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
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 rR 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:
APPLICANT PRINTED NAME:
APPLICANT TITLE:
Aziz HaQ
Engineer
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
10/14/21
City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021
SIGN SPACING
= X
FREEWAYS & EXPRESSWAYS
55 170 MPH
1500't
RURAL HIGHWAYS
60 /65 MPH
800'1
RURAL ROADS
45 155 MPH
500'±
RURAL ROADS & URBAN ARTERIALS
35 140 MPH
350't
RURAL ROADS & URBAN ARTERIALS
RESIDENTAL & BUSINESS DISTRICTS
25 /30 MPH
200'3 (2)
URBAN STREETS
25 MPH OR LESS
100't (2)
(1) ALL SPACING MAY BE ADJUSTED TO ACCOMMODATE INTERCHANGE
RAMPS., AT -GRADE INTERSECTIONS AND DRIVEWAYS.
(2) THIS SPACING MAY BE REDUCED IN URBAN AREAS TO FIT
ROADWAY CONDITIONS.
ROAD
+ t
CLOSED
AHEAD
W20.3
DETOUR
AHEAD
W20.2
241' x 24"
SPEED
LIMIT5
Q
R3.2
f 88th St SIN
TABLE (1)
CHANNELIZATION DEVICE
SPACING (feet)
MPH TAPER TANGENT
50/70 40 80
35/45 30 60
25/30 20 40
MANDATORY
CLOSURE AFFECTS RESIDENTS
DRIVEWAYS.
PROPERTY OWNER PERMISSION
REQUIRED TO BLOCK DRIVEWAYS.
NOTIFY AFFECTED RESIDENTS OF
WORK TIMES/DATES.
NO SIDEWILK THIS
SIDE OF STREET
60" x 48" 24�" x 24''
ROAD DETOUR TO
AHEAD
ROAD CLOSED
CLOSED AHEAD THRU TRAFFIC 1♦
W20.3 W20.2 R7i�
R34
DETOUR
AHEAD
ADVANCE WARNING SIGNS
SPACED @ (K) OR AS PER ,� W70,2
SITE CONDITIONS.
REFER TO SIGN SPACING CHART. I ROAD
00 CLOSED
AHEAD W20.3
GENERAL NOTES:
1.
ALL SIGNS AND SPACING SHALL CONFORM TO THE MUTCD SPECS.
2.
NOTIFY LOCAL EMERGENCY SERVICES OF CLOSURE TIMES AND
DATES (OPTIONAL).
RECEIVED
3.
SIGN SPACING MAY BE REDUCED IN URBAN AREAS TO FIT ROAD
CONDITIONS.
OCT 15 2021
4.
PROTECTIVE VEHICLE RECOMMENDED.MAY BE A WORK TRUCK.
5.
ALL SIGNS MIN. 48" K 48" UNLESS OTHERWISE SPECIFIED.
6.
CHANNELIZATION DEVICES ARE 28"' REFL. CONES (see TABLE (1)
for spacing distances).
CITY OF EDMONDS
7.
ALL SPACING MAY BE ADJUSTED TO ACCOMMODATE AT.GRADE
DEVELOPMENT
SERVICES DEPARTMENT
INTERSECTIONS AND/OR DRIVEWAYS.
ical Road Closvra w/ Da+torr
O W/B 188th St SW closed between 83rd Ave W & 84th Ave W.
O Local access maintained for residents.
O Sidewalk on the south side of 188th St SW unaffected.
O Parking Lane not present.
O Transit route not present.
O REASON: To replace all antenna egvipment on OKisting
Pole / Cell Site.
O Egmipment needed to perform task shall take up the entire
width of roadway.
0
0
48' x 6U'
ROAD
481' x 301'
WILL BE
LOCA ROAD
CLOSED
CCES
UNEIN CLOSED
c/gdnc TO diachoc
K AM TO K PM
e
R11
RS S.1501
SEE INSET BELOW
INST! LL If D% YS
FOR DETOUR ROUTE
PRIOR TO CLOSURE
DETA-ILS
TRAFFIC CONTROL PLAN
EDMONDS, WA
N
W E
S
NOT TO SCALE
SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM
RESIDENCE: RESIDENCE:
8317188th St SW 8307188th St SW 60Fx48P
Edmonds, WA 98026 Edmonds, WA 98026 ROAD To
CLOSED
THRU TRAFFIC
Cell Site R57.4
0)
24" x 241'
T-
R34
RESIDENCE: RESIDENCE:
8314188+th St SW 8302 188th St SW
Edmonds, WA 98026 Edmonds, WA 98026
ADVANCE WARNING SIGNS
SPACED @ (K) OR AS PER
SITE CONDITIONS.
REFER TO SIGN SPACING CHART.
SIDEWILK MA—INTIINED 241' x 24P
THIS SIDE OF STREET r'-0
R33,2
DETOUR
AHEAD
W20.2
V2
Go
*W20,3
LEGEND
® WORK AREA
❑ ❑ ❑ ❑ ❑ 28"' REFL. CONE
CONTRrt C"
t-I SIGN LOCATION SUPERVISI
Aziz Ha
7m--7 PROTECTIVE/WORK VEHICLE PHONE NU
® POLE LOCATION
(Cell Site)
DETOUR ROAD
AHEAD CLOSED
AHEAD
W20.2 W20.3
f 88th St SIN
ENGINEERING DIVISION
APPROVED AS NOTED
%a UI &J,,,,44z 10/18/2021
vv
k1ASHIk'G7O&' STA*E TRAFFIC CO&7ROL
SUPERVISOR
ROAD
WORK
.h AP7E: Greg Siler AHEAD
rCS CARD # 012604
EXP. DATE 1013112024
Greg SiJ,zr
PUBLIC UTILITY"DISTRICTNO.
T-MOBILE PERRINVILLE - SE01553E
[Pl n V n lIDD (- nl\ICTDI I(`TT(ll\I nDCD ATInI\IC ANIr) CNI(`TNICCDTNI(` DCOI ICCT
VVI\IJ I I\U\_ 1 PJ11I VI LI\P71 1lJIVJ P71\1U
LI\IVIIVLLI\II\1U \L\�UL_ ) 1
1818 Rev. 4/19
TO
FROM
DATE
KEITH ELLISON
AZIZ HAQ 425-319-4209
10/14/21
ADDRESS/LOCATION/POLE NUMBER
8307 188TH ST SW, LYNNWOOD,
WA / 18(27-4)NE //
PLI:229080
MAP NO.
ORDER NO.
OPERATION NO.
454—J3
100085922
30
ACTION•
PLEASE ASSIST T—MOBILE WITH THE REPAIR OF THEIR ANTENNA SITE RECEIVED
OCT 15 2021
TROUBLESHOOT GAMMA AND BETA
SECTORS, REPLACE RADIO
AS NEEDED
POLE HEIGHT: 93' AOL
CITY OF EDMONDS
SERVICES DEPARTMENT
OUTAGE WINDOW:
1151kV SCHEMATIC
PLAN VIEW
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28 MVA
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For de -energizing customer service
for Customer work
CUSTOMER CREW HOURS
When completed,
cnllthe PUD nt 42 -783-1000or (1-877-783-10 T as`cror -Energy-75ntrol-
Customer Signature
Date
ACTIONOR
OTHER ACTIONREQUIRED
APPROVED BY
COMPLETED BY
DATE
'Dispc
Distribution: White -Department Responsible For Work -Return To Originator When CompletedCan&yefl(aprt6ibntARe6pdkBibleC(FroplON6rk'' RdeOEig