ENG2021-0536 ROW PERMITOF WAY EUC PERMIT
PERMITNUMBER,
City of Edmonds
EdmondsRIGHT
•:• • 1 1
www.cityofedmonds.gov• •
Description: ZIPLY-REMOVE BARE POLE ISSUED: 01/12/2022
Address: 9823 238TH ST SW EDMONDS WA 98020-5648
EXPIRES: 07/12/2022
rmit Type: RIGHT OF WAY EUC Permit Subtype: MINOR Parcel Number: 00446300000500
i
NAME TYPE NAME ADDRESS PHONE
APPLICANT MIKE HAKAHAN 1800 41ST ST STE N100, EVERETT WA 98203 (425)949-0230
CONTACT ZIPLY FIBER 1800 41ST ST STE N100, EVERETT WA 98203 (425)949-0230
CONTRACTOR PACIFIC CABLE CONSTRUCTION PO BOX 573, WOODINVILLE WA 98072 (425)348-7735
OWNER EDWARD PAUL III & MAR RIEGERT 9823 238TH ST SW, EDMONDS WA 98020
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE CHARGED PER PERMIT
$40.00 $40.00
RIGHT OF WAY MINOR - EUC PERMIT FEE
$110.00 $110.00
1111
•
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
01 /12/2022
RELEASED BY
DATE
Printed: Wednesday, January 12, 2022 12:32:34 PM 1 of 2
-KRWOF WAY EUC PERMIT
City of • • •
•:• •ENG2021-05,136
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.
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.
INSPECTIONS
INSPECTION TYPE
DATE
RESULT
COMPLETE
A-1 JOB START
X-2 ENGINEERING FINAL"
E-7 TRAFFIC CTRL
Printed: Wednesday, January 12, 2022 12:32:34 PM 2 of 2
ENG2021-0536
of EDM041.� RECEIVED
RIGHT OF WAY CONSTRUCTION DEC 29 2021
PERMIT APPLICATION
Complete and submit this Application in accordance with the Submittal CITY OF EDMONDS
/Iv . i s`0 Requirements outlined in Right -of -Way 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.
SECTION A
General •
Project Name 5223897-751
Site Address or if no site address use Property Address at NW corner of project area: 9823 238th St SW, Edmonds
Associated Permits: BLD PLN ENG
Owner and Entity Holding Franchise (if applicable)
Name of Company Ziply Fiber Franchise Ordinance No: WN U-17
Point of Contact Mike HaKahan
Title Engineer
Address 1800 41 St St, Ste N 100
city Everett
State WA
Zip 98203
Phone 425-949-0230
Email mike.hakahan@ziply.com
Contractor and Authorized Agent of Owner (see note below)
Name of company Pacific Cable Construction
Contractor Contacts
Primary Name
During Construction
Danielle Harrera
Agent Name Danielle Herrera
Title
Permit Manager
Title Permit Manager
Mobile
425-348-7735
Address PO BOX 573
Email
danielle@paccab.com
City Woodinville
State WA
Zip 98072
Secondary Name
Phone 425-348-7735
Title
Email danielle@paccab.com
Mobile
City of Edmonds Business License No: PACI FCC954PJ
Email
State License No: 3636CON 1096
Of
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
❑��T��raffic Control Only (no associated development)
VO tility 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.)
Application is to document work completed in the field to remove bare pole. All work is complete, pole removed.
Associated with PUD JPN 395528-3 permitted under ENG2016-0369.
Tracked on City of Edmonds spreadsheet "EUC Not Complete" on line 15.
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:
VZtelecommunications ❑ 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?
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?
X
If yes, answer the following questions related to project area, i.e. the actual area in which the
project is proposed:
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? 1
What is the height of the existing poles? 30
How many poles are to be removed? 1
Are additional poles to be laced? No.
How many? I U I What is the height of the additionalpoles? I NA
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:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021
RECEIVED
DEC 29 2021
CITY OF EDMONDS
Right -of -Way Application #1069561 - 5223897-751
MyBuildingPerrnit
com
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
Applicant
First Name Last Name Company Name
Mike HaKahan Ziply Fiber
Number Street Apartment or Suite Number E-mail Address
1800 41st St Ste N100 mike.hakahan@ziply.com
City State Zip Phone Number Extension
Everett WA 98203 425-949-0230
Contractor
Company Name
PACIFIC CABLE CONSTRUCTION INC
Number Street Apartment or Suite Number
PO Box 573
City State Zip Phone Number Extension
Woodinville WA 98072 425-348-7735
State License Number License Expiration Date UBI # E-mail Address
PACIFCC954PJ 10/21/2023 FDD5877Dq danielle@paccab.com
Project Location
Number Street Floor Number Suite or Room Number
9823 238TH ST SW
City Zip Code County Parcel Number
EDMONDS 98020 00446300000500
Associated Building Permit Number Tenant Name
N/A
Additional Information (i.e. equipment location or special instructions)_
Work Location
Property Owner
First Name Last Name or Company Name
Edward Paul lii & Marissa Kay Riegert
Number Street Apartment or Suite Number
9823 238TH ST SW
City State Zip
EDMONDS WA 98020
Certification Statement - The applicant states:
I certify that I am the owner of this property or the owner's authorized agent. If acting as an authorized agent, I further certify that I have full power and
authority to file this application and to perform, on behalf of the owner, all acts required to enable the jurisdiction to process and review such application. I
have furnished true and correct information. I will comply with all provisions of law and ordinance governing this type of application. If the scope of work
requires a licensed contractor to perform the work, the information will be provided prior to permit issuance.
Date Submitted: 12/29/2021 Submitted By: Mike HaKahan
Page 1 of 2
i
CITY OF EDMONDS MyBuildingPermit.com
Right -of -Way Application #1069561 - 5223897-751
Project Contact
Company Name: Ziply Fiber
Name: Mike HaKahan Email: mike.hakahan@ziply.com
Address: 1800 41st St Ste N100 Phone #: 425-949-0230
Everett WA 98203
Project Type Activity Type Scope of Work
Franchise Utility Franchise Utility Work No Disturbance of Surface
Project Name: 5223897-751
Description of Application is to document work completed in the field to remove bare pole. All work is
Work: complete, pole removed. Associated with PUD JPN 395528-3 permitted under
ENG2016-0369. Tracked on City of Edmonds spreadsheet "EUC Not Complete" on line 15.
Project Details
Project Information
Job Number
5223897-751
Page 2 of 2
SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM
MI
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ENGINEERING DIVISION
APPROVED AS NOTED
Jill (Al4J,,,,44z 01 /11 /2022
VV
Applicant shall repair/replace all
damage to utilities or frontage
improvements in City right-of-way
per city standards that is caused or
occurs during the permitted project.
°
4
=
fo
. e,
=
+!\r
i�1Klt7[J-o5�9fjo17. 6H 3
=r
— + M� rwaa
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�—S7� PLAN VIEW
FTR 716807 T �! `�
`n •• �G,
��j �Z�
PO1B - 1 - Remove Pole FTR 716726
moss
POSA - 1 - Transfer Attachment PO - 1 - Remove Pole
Y
from 2
Z2
P08A - 2 - Place/Remove Down Guy POSA SA - 3 - Transfer Attachment
FTR 716733
FTR 716704
FTR 108968
P221 - 217 � De -lash 8 Re -lash POSH - 2 - Transfer Riser
PO18 - 1 - Remove Pole
-
P36D - 4 Transfer Drop
PO1B - 1 -Remove Pole
-
D368 2 -Remove Drop P078 - 1 -Remove Anchor & DG
POSA - 3 - Transfer Attachment
SP53 - 1 - Install Pole Tag
POSA - 2 - Transfer Attachment
P36D - 3 - Transfer Drop
P47B - 2 - Place/Remove Down Guy
Pllg - 2 -Place Arm
P07B - l - Remove Anchor& DG _
SP53 1 -Install Pole Tag P47B - 35 - Tree Trimmg
P11D - 1 - Remove Arm
21
POSA - 3 - Place/Remove Down Guy
P57A - 10 - Hand Trench
P36D - 9 -Transfer Drop
FTR 721810
P11B - 2 - Place Arm •^
S SP53 - 1 -Install Pole Tag
P47B - 60 - Tree TrimmingPOIB
- 1 - Remove Pole
P- 2 - Remove Arm ° F
FTR 721814
5148 - 3 -Place/Remove NO
POSA - 2 - Transfer Attachment
P22J 22J - 361 - De -Lash & Re -Lash
PO18 - 1 - Remove Pole D
SPS3 - 1 - Install Pole Tag
PI1D - 2 - Place Arm
P36D - 11 - Transfer Drop n[°r,rior
P05A - 1 - Transfer Attachment FTR 716702
P11D -I -Remove Arm
P47B - 80 - Tree Trimming
SP53 - 1 - Install Dole Tag
P5AOIB - 1 - Remove Pole
2
P368 - 1 - Remove Drop
SP53 - 1 - Install Pole Ta g trrn
P05A - 1 - Transfer Attachment
FTR 721811
P018 - 1 -Remove Pole
P36D - 6 - Transfer Drop
P47B - 20 -Tree Trimming
ow+
Z3
P11D - 1 -Remove Arm
P18A - 6 - Place Strand
POSA - 1 - Transfer Attachment
S148 - 2 - Place/Remove NID
P018 - 1 - Remove Pole [r,tA
P36D - 1 - Remove Drop
D07B - 2 - Remove Anchor & DG
SP53 - 1 - Install Pole Tag
P05A - 1 - Transfer Attachment wo [
P36D - IS - Transfer Drop
P08A - 1 - Place Down Guy
P079 - 1 - Remove Anchor & DG
WEP18B
S148 - 2 - Place NID
- 100 - Remove Strand
POSA - 1 - Place Down Guy
SP53 - 1 -Install Pole Tag
SPS3 - 1 - Install Pole Tag
RECEIVED
I `
ZI 5223897-751
DEC 29 2021
PAGE 2 OF 2
3
OWNER/CONTRACTOR RESPONSIBLE FOR LOCATING
CITY OF EDMONDS
OWNER/CONTRACTOR IS RESPONSIBLE FOR
ALL ON SITE UTILITIES. RELOCATION/REVISION
TO ANY
DEVELOPMENT
SERVICES DEPARTMENT
EROSION CONTROL AND DRAINAGE
UTILITIES MAY REQUIRE A SEPERATE PERMIT.
All work completed TCP filler only.
BUFFER DATA
LONGITUDINAL BUFFER SPACE = B
SPEED (MPH)
25
30
35
40
45
50
55
60
65
70
LENGTH ftet)
155
200
250
305
360
425
495
570
645
730
TRANSPORTABLE ATTENUATOR ROLL AHEAD DISTANCE = R
HOST VEHICLE WEIGHT
9,900 TO 22,000 Ibs.
HOST VEHICLE WEIGHT
> 22,000 Ibs-
45 MPH
45-55 MPH
> 55 MPH
< 45 MPH
45-55 MPH
> 55 MPH
100'
123'
172'
74'
100'
15C
PROTECTIVE VEHICLE (WORK VEHICLE) = R
NO SPECIFIED DISTANCE REQUIRED
NE LAN
ROAD
.
AHEAD
0114
�
�7A
ROAD
BE
WORK
PREPARED
HEA
TO STOP
VAI
11mb-79
W20-]B (OPTIONAL IF
46 MPH OR LESS)
LEGEND
FLAGGING STATION
q
TEMPORARY SIGN LOCATION
®
CHANNELIZING DEVICES
®
PROTECTIVE VEHICLE
RECEIVED
DEC 29 2021
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
SIGN SPACING = % (1)
RURAL
RURAL ROAOSAVS 45I 55 MPH 500' W20-]B(OPTIONAL IF
RURAL ROAD3 S URBAN ARTERIALS 35140 MPH 350' 40 MPH OR LESS)
TIRESIDENTIALL& BUSINESS DISTRICURBAN TS 25130 MPH 200' (2)
URBAN STREETS 25 MPH OR LESS 100 (2) BE ROAD
(INTERIRAI NO SECTIONS AND DRIVEWAYS. TO ACCOMMODATE PREPARED WORK
(2�THISWAVCON MAIONSE REDUCED IN URBAN AREAS TO FIT TO STOP HEA
.� NE LAND
ROAD
AHEAD
7A V4
o®
BE
PREPARED W20-]8(OPTIONAL IF
44 MPH OR LESS)
TO STOP
IE LAN VANIII-11111
ROAD
4LEAD
M-4 ROAD
WORK NOTES
LEA
ONE —LANE, TNfl-1IfYGT gIC CONTROL
NOT TO SCALE
zzoznno
4310N SV CEAObddV
NOISUAId ONI�IEINION:3
1
2
3
4,
CHANNELIZATION DEVICE
SPACING (FEET)
MPH TAPER TANGENT
50165 10 TO 20 30
35I45
25I30 10 TO 20 40
S-BUILT
•
Zipberly-
f
Date4dp-- By &L-
Exchange: 51419 Halls Lake
Project. 5223897-751
Address. 9823 238th St SW, Edmonds, WA
Notes: Pole ' Z4" as referred to on line 15 of City of
Edmonds "EUC Not Complete" spreadsheet has been
removed and all work is completed in the field. This
permit is to close work and recognize completion of PUD
JPN 395528-3 associated with ENG2016-0369.
Afyll��
PPRROVEDPROJJECT
Mike HaKahan
Ziply OSP Engineer
mike.hakahan(@zir)lv.com
425-949-0230
Aply
RECEIVED
DEC 29 2021
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
PAGE 1 OF 2
ri
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APPIEN00Ed a S. 112& q 3�1
"ter" JOINT POO.IE NOTOPOCAToom /�.
1112 Re, 7/10 Year Price List
ro'o ICATV: RONTIER Etcnorlge Dote
RONTIERu Irl COMCAST Lt/RVEt<j�g/l/t6,^ rn rI Customer Name Service A,dr;Ac; = �N SNOHOMISH COUNTY PUD $0 P—dJF
win, 1 nrA�lnr c i., n
PUD WO/Tosk No.
/ 003
PUD En n+aerT
vvy ��9 PUD Aptor eyed395528
YASAMIN ZADEHGOL (425INTENDS
TO PERFORM THE FOLLOWING ON THIS WORK ORDER:Out SEP 1 6 20t6l
Poles ❑ Set _ Addibonol8• HMAY 0 9 ?w IZ Poles ❑Se t� Add!
7(onReplace
I� onoll2's In QZ?ZQI6minote Poles From PUD Syslen• ❑Cuslomer Po, IOO7 Contacts fR
To Ccnlod FRONTIER Po'e(sl Al Locotiontsl
BM N; mloerOtherFRONTIER
Poy /5% Of The Follo IEstim
•in9 ales Skcyl
PUO Work Completed
Easemenl Esrmole
FRONTIER Tronsfer�
sferr
, u.+T�
PEASE SEE PAGE 3 OF 4 IN ATTACHED CONSTRUCTION DRAWING
RETURN TO JOINT USE BY:
PLVA66 ExMDRE
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FOR FRONTIER USE ONLY FRONTIER ACCEPTS THE FOLLOWING [—]NO JOINT USE
Pek/Catalan
Relerence
-
i
S
Srse
ReeorerY
tyie/Veorl Cost
PeeiLocol'on
Rererencc
w i
SZe
Recovery
(Sae/rears
Cosl
P361
w
10(
1173.70
117370
V
Addit'onol Anchors At The Fo4owing Locations WO/USDA Codes
Fielde Date Approved By: