ENG2021-0421 ROW PERMITRIGHT OF WAY EUC PERMIT
PERMIT NUMBELIR,
City of Edmonds
121 5th Ave N, Edmonds ...0iENG2021-0421
www.cityofedmonds.gov
Description: PSE-INSTALL GAS SERVICE W/ PAVING CUT ISSUED: 11/09/2021
Address: 529 9TH AVE N EDMONDS WA 98020-3038
EXPIRES: 05/09/2022
rmit Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 27032400220900
I 11-1411 a
i
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 TOURTELLOTJUDITH 529 9TH AVE N, EDMONDS WA 98020-3038
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE CHARGED PER PERMIT
$40.00 $0.00
ENGINEERING INSPECTION FEE
$330.00 $0.00
RIGHT OF WAY STANDARD - EUC PERMIT FEE
$330.00 $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
11 /09/2021
:»•>/F9:1H ]1
DATE
Printed: Tuesday, November 09, 20213:29:58 PM 1 of 2
-KRWOF WAY EUC PERMIT
PERMIT NUMBER
City of Edmonds
...• •ENG2021-0421
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.
Applicant, on behalf of his or her spouse, heirs, assigns, and successors in interests, agrees to
indemnify defend and hold harmless the City of Edmonds, Washington, its officials, employees, and
agents from any and all claims for damages of whatever nature, arising directly or indirectly from the
HOLD HARMLESS
issuance for this permit. Issuance of this permit shall not be deemed to modify, waive or reduce any
requirements of any City ordinance nor limit in any way the City's ability to enforce any ordinance
provision.
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.
L
11111
0
INSPECTION TYPE
DATE RESULT
NOTES
COMPLETE
A-1 JOB START
X-2 ENGINEERING FINAL"
E-7 TRAFFIC CTRL
E-7 RESTOR LIMITS
E-7 CONCRETE SIDEWALK
E-7 CURB GUTTER
Printed: Tuesday, November 09, 2021 3:29:58 PM 2 of 2
ENG2021-0421
of EpM04O�
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SECTION A
RIGHT OF WAY CONSTRUCTION
PERMIT APPLICATION
Complete and submit this Application in accordance with the Submittal
Requirements outlined in Right-of-Wgy permit Handout E6�.
RECEIVED
1►romilW41 ail
CITY OF EDMONDS
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 106382101
Site Address or if no site address use Property Address at NW corner of project area: 529 9th 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 EKSingle 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 14' W c/1 of 9th AVE N & 272' N c/1 of N Daley St (1) 4x6 paving cut
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
1-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?
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:
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: 11/1/2021
APPLICANT PRINTED NAME: SusanSidick
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
Job #:
Date:
Jurisdiction:
ROW Permit:
Est. Start Date:
Est. Duration:
106382101
10/25/21
Edmonds
Yes
12/27/21
1 Day (8 Hours)
Puget Sound Energy Gas Pre -Inspect Form
Address:
City / Zip:
Customer:
PM / Inspector
RECEIVED
Nov 01 2021
CITY OF EDMONDS
DEVELOPMENT SERVICES
DEPARTMENT
529 9th Ave N
Edmonds, 98020
Cody Danson 425-275-2294
Ariella Emlen 804-944-7012
Job Description
Project Scope: From 2" STW main on 9th AVE N- Install approx. 62' of 1-1/8" PE scat svc (12' Stub / 50' Ext) in PSE provided trench New Construction:
and set A250 meter out left No
PLAT Map: 162.066
RESTORATION LIMITS TO BE
DETERMINED BY CITY --.-------
NSPECTOR. ..............................
SIDEWALK AND CURB -GUTTER
RESTORATION TO MEET CITY
STANDARDS (SEE ATTACHED
STANDARD DETAILS). ............
rn
N
PL
64' ROW
0
IConstruction Method I
All Scat / Trenchless
ENGINEERING DIVISION
APPROVED AS NOTED
11 /05/2021
PL
!III Glen ST
M
3
a,
H Applicant shall repair/replace all
damage to utilities or frontage
improvements in City right-of-way
PL per city standards that is caused or
occurs during the permitted project.
OWNER/CONTRACTOR IS RESPONSIBLE FOR
EROSION CONTROL AND DRAINAGE
Work
Location
Size of Cut
Surface Type
14'
West
of CL
9th Ave N
&
272'
North
of CL
N Daley St
4 X 6 X
A
of CL
&
of CL
of CL
&
of CL
of CL
&
of CL
of CL
&
of CL
Service Information
Street Information
Job Type
Diameter:
1-1/8" PE
Flaggers #:
1
Arterial:
Yes
New Residential Svc
EFV:
1-1/8" - 2600 - 9999144
Police #:
0
TCP:
Yes
Tie -In Fitting
Meter:
A250
Speed Limit:
25
No Parks #:
6
Steel - 1" Sery x 1/8" PE Outlet (MOP) - 125
1 9997039
Meter Loc:
03 - OL
Trolley Lines:
No
Mtr Hoods #:
0
Del Press:
6" W.C.
Traffic Signal:
I No
Bus Stop:
No
SNO YRD -Snohomish ".
Bollards:
2.5" #
4" #
ADA Ramps #:
0
Route #'s:
ml
1111 n �.(`—. I - - 1 — nnw
CURB/GUTTER
SEE COE STD
DTL TR-520
PLAN VIEW
(NOT TO SCALE)
5' MIN
FULL DEPTH 1/2" EXPANSION
JOINT MATERIAL
2% MAX
d
1/2" R a s a
a
d < 1/2" R
a d
�WMQI&�lf "-2" MIN 5/8" MINUS CSTC
ON NATIVE BEARING SOIL
SECTION VIEW SEE NOTE 9
NOTES: (NOT TO SCALE)
1. CITY INSPECTION REQUIRED ON FORM WORK PRIOR TO POUR.
2. CONCRETE SHALL BE CLASS 3000.
3. FINISH SHALL BE LIGHT BROOM.
4. SIDEWALK THICKNESS SHALL BE 4".
5. SIDEWALK THICKNESS AT DRIVEWAYS SHALL BE 6" THICK.
6. CURB AND GUTTER SHALL BE POURED SEPARATELY FROM SIDEWALK.
7. LIDS FOR JUNCTION BOXES AND UTILITY VAULTS SHALL BE NON-SKID AS SPECIFIED BY ENGINEER.
8. SEE COE STD DTL TR-550 FOR POSSIBLE ROOT BARRIER INSTALLATION.
9. SUBGRADE SHALL BE COMPACTED TO 95% MAXIMUM DENSITY.
10. ALL EDGES WITH EXPANSION JOINTS SHALL HAVE I" RADIUS
CITY OF EDMONDS
PUBLIC WORKS
DEPARTMENT
`St. 18y-
CONCRETE SIDEWALK
APPROVED BY: R. ENGLISH
m
REVISION DATE
JUNE 2019
STANDARD
DETAIL
TR-531
2' MINIMUM SAWCUT
R =1/2"
2" OF 5/8"
MINUS CSTC
NOTES:
STANDARD TYPE "A" CURB/GUTTER
(NOT TO SCALE)
HMA DEPTH SHALL BE
4" FOR RESIDENTIAL ROADS
AND 6" FOR ARTERIALS AND
COLLECTORS
SEE NOTE 12
6" CSTC OR CSBC PER WSDOT
STD SPEC 9-03.9(3)
SEE NOTE 13
1. CITY INSPECTION REQUIRED ON FORM WORK PRIOR TO POUR.
2. FORMS SHALL BE TRUE TO LINE AND GRADE AND SECURELY STAKED.
3. FULL DEPTH EXPANSION JOINTS SHALL BE PLACED ADJACENT TO ANY STRUCTURE.
4. FULL DEPTH EXPANSION JOINTS SHALL BE PLACED EVERY 10 FEET.
5. FULL DEPTH EXPANSION JOINTS SHALL HAVE 1/2" WIDE PREMOLDED JOINT FILLER.
6. CONCRETE SHALL BE CLASS 3000/COMMERCIAL MIX.
7. FINISH SHALL BE LIGHT BROOM.
8. CURB AND GUTTER SHALL BE SPRAYED WITH CLEAR CURING COMPOUND OR SHALL BE COVERED AND KEPT MOIST FOR
72 HOURS.
9. REMOVAL/REPLACEMENT OF CONCRETE CURB SHALL BE FROM EXPANSION JOINT TO EXPANSION JOINT, UNLESS
OTHERWISE DIRECTED BY CITY ENGINEER.
10. A 2-FT MINIMUM ASPHALT SAWCUT MAY BE REQUIRED WHEN EXISTING PAVEMENT WOULD ABUT NEW CURB/GUTTER.
11. CURB/GUTTER SHALL BE 18" OR AS DIRECTED BY CITY ENGINEER. REFER TO CITY STANDARD CONCRETE CURB AND
GUTTER DETAIL TR-520.
12. FINAL JOINT SHALL BE A NEAT SAW CUT STRAIGHT LINE. ALL EXPOSED VERTICAL EDGES SHALL BE TACKED NEATLY PER
WSDOT STANDARD SPECIFICATION 5-04.3(4) APPROVED TACK OR APPROVED EQUAL AND SEALED PER WSDOT STD
5-04.3(4)A.
13. CSTC SHALL BE INSTALLED UNDER HMA WHEN HMA SAWCUT IS REQUIRED. CSBC SHALL BE INSTALLED UNDER HMA
WHEN FULL ROAD RECONSTRUCTION IS REQUIRED.
14. NATIVE AND GRAVEL SUBGRADE SHALL BE COMPACTED TO A MINIMUM OF 95% MAX DENSITY.
`St. JB9-
tjAPRIL
SION DATE
CITY OF EDMONDS VERTICAL 2021
CONCRETE CURB
PUBLIC WORKS AND GUTTER STANDARD
DEPARTMENT DETAI L
APPROVED BY: R. ENGLISH T R- 5 2 0
100,
��
noo
ono
W20-1
W20-4
Notes:
1. All signs and spacing to conform to the
MUTCD and City of Bothell 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 224th St SW & 210' ECL
1st PI W.
100,
A
—H ,
O D M.
W3-4
LEGEND
®
28" TRAFFIC CONE
®
WORK PIT
TRAFFIC FLOW
FLAGGER
WORK VEHICLE/
FLASHING LIGHTS
SIGN LOCATION
RIGHT OF WAY
Row
y
r
No
TEMPORARY TRAFFIC CONTROL PLAN
M
224TH ST SW
13 113 70/1
b. Q W20-7A #110
o
QD
° oo
ROAD
WORK N VV20-4
IAHEAD 04
I
SIGN SPACING
MPH
"X"
60/65
1000,
45/55
500'
35/40
350'
30
200'
25
100'
CHANNELIZATION
DEVICE SPACING
MPH
TAPER
TANGENT
55/70
40
80
35/45
30
60
25/30
20
40
1- ZOZ/SO/ 11
4310N S`d GDAO2Jdc!V
NOISIAIG JNRJ33NIJN3
W20-4
Km
VL-OZM � 6-OZM
100,
a
RESIDENT(S) WILL BE INFORMED
OF POSSIBLE TEMPORARY
DRIVEWAY CLOSURE
1N3NiHVd30
JziJI/ a of BYe n�u
PUGET Designer: s � sor REV
SOUND Prachi Joshi Gre o Ha wood 10/27/2021 0
N� QZo
ENERGY 425-354-8457 d E p. 9/30/202 Job #
gory. harwood@pse.cJfqPQaom
106382244
prachi.joshi@pse.com gregory.hamood@pse.com
3 2
Project Address:
110 224TH ST SW Bothell I Page 1 OF 1
_
3
-
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1 1 /4" PE IP 10'S-N PL 3
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995
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873129 1372'E
In
5
802
816
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N
818
988
104S
5/8' PE
1987
804
141'S
31
172S
814
5/8" PE
5/8" PE
0
1987
1987
518"
1 1 /8" MPE
2014-E
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5/8" PE
a�
2019MPE
645
808
i
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810
1987
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1998
520 528
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1991
1992 a b
707
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1964
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657 68'S
647
5/8'MPE 2 1'S
2003
2 3'
194'S
643
529
43'N
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2007-E
604
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1994
702
612
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19
1989
923
920
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2006-E
EN
925
930
530
288'N
1 1 /4" MPE
2009-E
1 MPE 5'N
2007-07-E 930 20004MPE
510 514
509
503 _P
11/8"MPEI
RECEIVED
522
11/8'MPE
75'S
w
2005
Nov
01 2021
UNK
OWN
UN
NOW
OF EDMONDS
NT SERVICES
DE
ARTMENT
771 U
KNO
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� 1
835
841
847
2013 MPE
2013
5/8" MPE
5/8" PE
96'
96'"
506
911
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2006-E
1993
1969SU
$
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1984
3/4"STW-U
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1989
853
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2002
1963
N�
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929
Scale 1:1012
No electric grid information available
S 160062, Q 162066
10-18-2021
Lat\Long=47.8146,-122.3674 OD
0 PUGET
SOUND ENERGY
,M x�vr �`M•'
The information on the attachetl maps is subject to change without notice. Puget Sound Energy makes no warranty. expressed or implied concerning
the suitability of this information for any purpose. Recipient agrees to not disclose this confidential information to any o}her person or entity.
unless authorized in writing by Puget Sound Energy. This map is not to be used for determining the
actual location of any PSE facilities (call 811)."