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ENG2021-0305 ROW PERMITOF WAY EUC PERMIT PERMIT NUMBER City of Edmonds AveRIGHT 9801 1 1 www.cityofedmonds.gov Description: PSE-INSTALL GAS SERVICE ISSUED: 12/22/2021 Address: 23525 74TH AVE W EDMONDS WA 98026-8500 EXPIRES: 06/20/2022 it Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 27043200200400 I 11-14111 a W 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 EASON JOHN / SCHADE JAYMIE SCHADE JAYMIE C, EDMONDS WA 98026 FEE INFORMATION DESCRIPTION AMOUNT PAID CITY TECHNOLOGY FEE CHARGED PER PERMIT $40.00 $0.00 ENGINEERING INSPECTION FEE $220.00 $0.00 ENGINEERING REVIEW FEE - OVER 3 REVIEWS $110.00 $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 ENGINEERING DIVISION APPROVED AS NOTED RELEASED BY DATE 12/22/2021 Printed: Wednesday, December 22, 2021 12:43:19 PM 1 of 2 -KRWOF WAY EUC PERMIT City of • • • Ave•:• • 1 1 1 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 INSPECTION MEN RESULT A-1 JOB START X-2 ENGINEERING FINAL" E-7 TRAFFIC CTRL E-7 RESTOR LIMITS Printed: Wednesday, December 22, 2021 12:43:19 PM 2 of 2 ENG2021-0305 of E°M041.� RECEIVED RIGHT OF WAY CONSTRUCTION AUG 05 2021 PERMIT APPLICATION Complete and submit this Application in accordance with the Submittal CITY OF EDMONDS /'1'c. i?0 Requirements outlined in Right-of-Waypermit 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. SECTION A General • Project Name 106377556 Site Address or if no site address use Property Address at NW corner of project area: 23525 74 AVE W 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 ExSingle 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.) To install gas service at approx 390' N c/1 of 236th ST SW & 7' E c/1 of 74th AVE W (1) 3x5 grass 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 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 d(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.)? xx 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? 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: 08/05/2021 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 AUG 05 2021 Job #: Date: Jurisdiction: ROW Permit: Est. Start Date: Est. Duration: 106377556 5/10/21 Edmonds Yes 7/16/21 1 Day (8 Hours) Puget Sound Energy Gas Pre -Inspect Form Address: City / Zip: Customer: PM / Inspector CITY OF EDMONDS DEVELOPMENT 23525 74TH AVE W SERVICES DEPARTMENT EDMONDS, 98026 RICHARD CHUNG 425-681-2831 Erik Bilstad 425-213-4286 Job Description / Scope of Work From 2" MPE IP main, install 53' - 1-1/8" PE scat svc. 8' scat stub and 45' scat ext. Set an A250 OR New Construction: o @ inches. 30' ROW. Construction Method All Scat / Trenchless PLAT Map: 166070 • WEOP OWNER/CONTRACTOR RESPONSIBLE FOR LOCATING => ALL ON SITE UTILITIES. RELOCATION/REVISION TO ANY Fire Hydrant 230' S S I UTILITIES MAY REQUIRE A SEPERATE PERMIT. from work zone- v III 11� � 1 a 23511 Utility be full half patches shall combined and width or 1 width overlay will be required depending on the extent 23521 1 11 of disturbance. Where utility patches fall entirely within I one travel lane, the overlay shall extend to the PE 1 I4 L centerline of roadway. Where utility patches extend into 9 I both travel lanes then a full width overlay is required. 11.1.1,1 I� I� 1 23525 IF, 5/8" PE 19s7 1 N 1 i� A250 23530 I N p I I - 9 sE 7415 1 I 1 j c 23565 Applicant shall repair/replace all 1 e damage to utilities or fronts I � 9 9 I I improvements in City right-of-way !� per city standards that is caused or occurs during the permitted project. ENGINEERING DIVISION 23577 APPROVED AS NOTED 7417 1 i OWNER/CONTRACTOR IS RESPONSIBLE FOR jdl (VQ✓.10, ,44,e 12/21/2021 1 ' EROSION CONTROL AND DRAINAGE VV g0P 1 Work Location Size of Cut Surface Type 390' North of CL 236th St SW & 7' East of CL 74th Ave W 3x5 Grass of CL & of CL of CL & of CL Service Information Street Information Job Type Diameter: 1-1/8" PE Flaggers #: Y Arterial: N New Residential Svc EFV: 1-1/8" - 2600 - 9999144 Police #: N TCP: Y Tie -In Fitting Meter: A250 Speed Limit: 20 No Parks #: N MDPE - 2" IPS - (DIA) 1"CTS Meter Loc: 04 - OL (rear) Trolley Lines: N Mtr Hoods #: N Del Press: 6" W.C. Traffic Signal: N Bus Stop: N ©� Bollards: 2.S" # 4" # ADA Ramps #:I N I Route #'s: N NOTIFY POLICE, FIRE, TRASH HAULERS AND EDMONDS SCHOOL DISTRICT 48 HOURS PRIOR TO ANY ROAD CLOSURE TEMPORARY TRAFFIC CONTROL PLAN 0 FLAGGER/SPOTTER TO ESCORT CYCLISTS AROUND WORK AREA RESIDENT(S) WILL BE INFORMED OF POSSIBLE TEMPORARY DRIVEWAY CLOSURE CREW SHALL SHIFT CONES AND EQUIPMENT FOR EMERGENCY VEHICLES ACCESS NOTIFY POLICE, FIRE, TRASH HAULERS AND EDMONDS SCHOOL DISTRICT 48 HOURS PRIOR TO ANY ROAD MAINTAIN OPEN BIKE LANE CLOSURE 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 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 390' NCL ofr 236th St SW and 7' ECL of 74th Ave W. 9. If used, place NO -PARK signs 72 hours in advance of the day that the work is to be done. a X-00 10O 75TH PL W j 14 l SIGN SPACING MPH "xn 60/65 1000, 45/55 500' 35/40 350' 30 200' 25 100' L 23525 74th Ave W Edmonds WA 98026 USA ENGINEERING DIVISION APPROVED AS NOTED Jill (,il &J,,, 44z 12/21 /2021 RECEIVED AUG 05 2021 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT CHANNELIZATION DEVICE SPACING MPH TAPER TANGENT 55/70 40 80 35/45 30 60 25/30 20 40 I EGEND ® 28" TRAFFIC CONE ® WORK PIT TRAFFIC FLOW WORK VEHICLE/ FLASHING LIGHTS SIGN LOCATION RIGHT OF WAY ROW - Puget Sound Energy REV D e s l g n e rTraffic Con trol Supervisor: .PUGET John Crofo05/21 /2021 0 SOUND John Crofoot Card No. got ENERGY 425-424-6658 John Crofoo"@'pse.com Job # John.Crofoot@PSE.com (425)424-6658 106377556 Project Address: 1"Vc'°i411 23525 74TH AVE W, EDMONDS, WA 98026 Page 1 OF 2 TEMPORARY TRAFFIC CONTROL PLAN NOTIFY POLICE, FIRE, TRASH HAULERS AND EDMONDS SCHOOL DISTRICT 48 HOURS PRIOR TO ANY ROAD CLOSURE lw 30th St SW :h St Svc 228th St SW 0 229th StSIV R11-4 � o Onp � o W v' c� o J DETOUR Ci7 r_l co anoiaa r 2 3 6t h ,9 (,spr kp R11-2 STREET CLOSED y y�0 QEjOv� a 9 ;StSW a s ��eeT way 00 13: mkr id St SW k -P3o, 2ib-6W cot oAL 1�n #R NGINEERING DIVISION APPROVED AS NOTED JX (,W,10,44z 12/21 /2021 vv L --- RESUB B al.l' m- DEC 01 2021 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT LEGEND ® 28" TRAFFIC CONE ® WORK PIT TRAFFIC FLOW WORK VEHICLE/ FLASHING LIGHTS SIGN LOCATION RIGHT OF WAY ROW Puget Sound Energy REV PUGET Designer: �oh�� Con ootl Supervisor: SOUND John Crofoot Ca d No.012613 12/01 /2021 1 ENERGY 425-424-6658 JohnCrof oot@pse.com Job # John.Crofoot@PSE.com o2s�z°-ease 106377556 Project Address: 23525 74TH AVE W, EDMONDS, WA 98026 Page 2 OF 2 .,. y ``ter. ........... 23429 23416 " rPE 23415 srrs 666E I good EI 23420 2. RPE I%3 ' 1996EPE ® 23431 23428 23429 23422 1Td NadMPE d51'N 1691 %YN 4 W.PE 23456 0 1%7 W PE 23423 23439 Z1reMPEa,23449 23432 - srs srePE t%I - m m u6s e so6 mod 23435 - 23514 23513 ;gip 23510 = 314—b 0 1%6 NI it MPE 23513 I6£ 111— E e z0N 0 23511 - - 23517 23520 = e MPE oorPE 23521 ML — 1�9 NI1R 1. Lfi Pf I%9 LAKE BALLINGER 3 - 23530 m - ��. ��- dddpppx µ — APE 1�96] E Q w°'"°=9d'ygogs"P ow 23527 23530 1 SrW � � �iy R iooe.EMPE 23565 7415 7526 7516 ot, I,6o ;dea ` E 7411 " I Ito• MPE� q 7417 23577 v 7504 23620 ,+ 23625 ar 7502 ,re MPE i e`' aoaE w 23615 RECEIVED AUG 05 2021 7515 ,srw 7519 23619 7507 \ 3 7 T H ST'° 5 CITY OF EDMONDS DEVELOPMENT -_ 7520 o 3.6rwIPITS _ podMPE SERVICES DEPARTMENT m zel als61 23702 23627 No electric and information available Scale 1:1519 S164068, 05-10-2021 Lat\Long=47.7851,-122.3327 ODQPUGETSOUNDENERGY The information on the attached maps is subject to change without notice. Puget Sound Energy makes no warranty, expressed or i mpned, concerning the suitability of this information for any purpose. Recipient agrees to not disclose this confidential information to any oth er person or entity, unless a,th,,,,,d in writing by Puget Sound Energy. This map is not to be used for determining the actual location of any PSE facilities (,.It 611)." 17-11 7-4$ ' 17-48A 1y25 �.17.-46 2341,15 23510 3521 23530 7415 7417 -134 23511 23525 23565 23575 RECEIVED AUG 05 2021 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT t i 1