ENG2021-0528 ROW PERMITOF WAY EUC PERMIT
PERMIT NUMBER
City of Edmonds
EdmondsRIGHT
121
IL 98020 1 1
www.cityofedmonds.gov
Description: PUD REPLACING EQUIPMENT ON POLE FOR T-MOBILE ISSUED: 01/24/2022
Address: 9726 EDMONDS WAY EDMONDS WA 98020-5940
EXPIRES: 07/24/2022
Permit Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 00434500000100
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 BERSCHAUER WALTER & DIANNE 19934 NW HOOD POINT RD, SEABECK WA 98380
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE CHARGED PER PERMIT
$40.00 $40.00
ENGINEERING INSPECTION FEE
$110.00 $0.00
RIGHT OF WAY STANDARD - WIRELESS PERMIT FEE
$330.00 $330.00
•
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
01 /24/2022
:»•>/F9:1H ]1
DATE
Printed: Monday, January 24, 2022 2:04:09 PM 1 of 2
-KRWOF WAY EUC PERMIT
City of • • •
Edmonds•:• •ENG2021-0528
31
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
E-7 TRAFFIC CTRL
X-2 ENGINEERING FINAL"
A-1 JOB START
Printed: Monday, January 24, 2022 2:04:09 PM 2 of 2
WO# 100088972
ofE°M0tio� RECEIVED
RIGHT OF WAY CONSTRUCTION DEC 22 2021
PERMIT APPLICATION
Complete and submit this Application in accordance with the Submittal CITY OF EDMONDS
is') 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 T-Mobile Edmonds Way Modification 2022
Site Address or if no site address use Property Address at NW corner of project area: 9720 Edmonds Way Edmonds, WA
Associated Permits: BLD PLN ENG
Owner and Entity Holding Franchise (if applicable)
Name of Company Snohomish County PLID No.1 Franchise Ordinance No: N/A
Point of Contact Aziz Haq
Title Transmission Engineer
Address P.O. Box 1107
City Everett
State WA
zip 98206
Phone 425-783-5251
Email Jointuse@snopud.com
Contractor and Authorized Agent of Owner
Name of Company Same info as above
(see note below)
Contractor Contacts During Construction
Primary Name
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
9 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
ix Traffic Control Only (no associated development)
R 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.)
Work will consists of replacing all pole mounted cell site equipment on the pole top. This work will require
two large bucket trucks to be setup in the right of way to lift material and land it on the pole. A lane closure shall be required in order
to accommodate the trucks. A double lane closure may end up being necessary depending on whether or not a crane is deemed necessary and if
local customers will let us utilize their parking lot(s). Ideal work hours would be 8AM to 5PM to utilize daylight. The project shall take roughly
5 to 7 days to complete depending on work hours and weather conditions. We will do our best to work with landlords to utilize parking lots and
minimize impacts in the right of way.
No tree trimming needed.
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 �a 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
X
No
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?
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?
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?
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
X
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?
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: AZIZ HAQ
APPLICANT TITLE: ENGINEER
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
12/21 /21
City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021
SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM
LANE CLOSURE ON A MULTI -LANE ROAD
Q
(V
J
N
NORTH
(OPTIONAL)
SIGN SPACING = X
FREEWAYS & EXPRESSWAYS
55-70 MPH
1500'±
RURAL HIGHWAYS
60-65 MPH
800'±
RURAL ROADS
45-55 MPH
500'±
RURAL ROADS & URBAN ARTERIALS
35-40 MPH
350'±
RURAL ROADS & URBAN ARTERIALS
RESIDENTIAL & BUSINESS DISTRICTS
25-30 MPH
200'± (2)
URBAN STREETS
25 MPH OR LESS
100'± (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.
NOTIFY WSDOT 48 TO 72 HOURS PRIOR TO
START OF WORK. CONTACT BONIE NAU AT
206-440-4471.
WORK HOURS - OFF PEAK ONLY
M-F 9 AM TO 3.30 PM
NO FEDERAL HOLIDAYS
SCHEDULE TRAFFIC CONTROL
INSPECTION FOR ALL DAYS ON SITE
LIGHTED ARROW
BOARD REQUIRED
x W1-4L
i
(V
J
x RIGHT
i LANE W20-5R
CLOSED
x AHEAD
ROAD
i WORK
AHEAD
W20-1
MINIMUM LANE CLOSURE TAPER LENGTH = L (FEET)
LANE WIDTH
POSTED SPEED (MPH)
(FEET)
25
30
35
40
45
1 50
55
60
65
70
10
105
150
205
270
450
500
550
-
-
-
11
115
165
225
295
495
550
605
660
-
-
12
125
180
245
320
540
600
660
720
780
840
ENGINEERING DIVISION
...,7TED
p( I (j_2V 11 /21 /2022
REVIEWED FOR TRAFFIC
CONTROL ONLY. SEE WIRELESS
ROW PERMIT ENG2021-0140
TABLE 1
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.
OWNER/CONTRACTOR IS RESPONSIBLE FOR
EROSION CONTROL AND DRAINAGE
RECEIVED
DEC 22 2021
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
CHANNELIZATION DEVICE
SPACING (FEET)
MPH
TAPER
TANGENT
50-70
40
80
35-45
30
60
25-30
20
40
GENERAL NOTES:
1. ALL SIGNS AND SPACING SHALL CONFORM TO THE MUTCD.
2. NOTIFY LOCAL EMERGENCY SERVICES OF CLOSURE TIMES AND
DATES (OPTIONAL).
3. SIGN SPACING MAY BE REDUCED IN URBAN AREAS TO FIT ROAD
CONDITIONS.
4. PROTECTIVE VEHICLE RECOMMENDED -MAY BE A WORK TRUCK.
5. ALL SIGNS MINIMUM 48" X 48", UNLESS OTHERWISE SPECIFIED.
6. CHANNELIZATION DEVICES ARE 28" REFLECTIVE CONES. SEE TABLE 1
FOR SPACING DISTANCES.
7. ALL SPACING MAY BE ADJUSTED TO ACCOMODATE AT -GRADE
INTERSECTIONS AND/OR DRIVEWAYS.
BUFFER DATA
LONGITUDINAL BUFFER SPACE = B
SPEED (MPH)
1 25
1 30
1 35
40
45
1 50
1 55
60
1 65
1 70
LENGTH (FEET)l
155
1 200
1 250
305
360
1 425
1 495
570
1 645
1 730
TRANSPORTABLE ATTENUATOR ROLL AHEAD DISTANCE = R
HOST VEHICLE WEIGHT
9,900 TO 22,000 LBS.
HOST VEHICLE WEIGHT
> 22,000 LBS.
< 45 MPH
45-55 MPH
> 55 MPH
< 45 MPH
45-55 MPHI
> 55 MPH
100' 1
123' 1
172'
74' 1
100' 1
150'
LEGEND
CHANNELIZING DEVICE
PORTABLE SIGN AND SUPPORT
WORK VEHICLE WITH FLASHING
LIGHT
WORK AREA
DOUBLE LANE
W20-1
R
Wo
AHEAD
CENTER X
W20-5MOD LANE
CLOSED
AHEAD X
N
J
(OPTIONAL)
(OPTIONAL) =
(OPTIONAL)
CLOSURE ON MULTI -LANE ROAD
SIGN SPACING = X
FREEWAYS & EXPRESSWAYS
55-70 MPH
1500'±
RURAL HIGHWAYS
60-65 MPH
800'±
RURAL ROADS
45-55 MPH
500'±
RURAL ROADS & URBAN ARTERIALS
35-40 MPH
350'±
RURAL ROADS & URBAN ARTERIALS
RESIDENTIAL & BUSINESS DISTRICTS
25-30 MPH
200'± (2)
URBAN STREETS
25 MPH OR LESS
100'± (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.
o—
)_ I — * W4-2L
cD
ZCL
o
W ..
a� LIGHTED ARROW
BOARD REQUIRED
I V4-2L RECEIVED
RIGHT TWO LANE DEC 22 2021
CLOSED W20-501
AHEAD
ROAD CITY OF EDMONDS
WORK v20-1 DEVELOPMENT
AHEAD SERVICES DEPARTMENT
GENERAL NOTES:
1. ALL SIGNS AND SPACING SHALL CONFORM TO THE MUTCD.
2. NOTIFY LOCAL EMERGENCY SERVICES OF CLOSURE TIMES AND
DATES (OPTIONAL).
3. SIGN SPACING MAY BE REDUCED IN URBAN AREAS TO FIT ROAD
CONDITIONS.
4. PROTECTIVE VEHICLE RECOMMENDED -MAY BE A WORK TRUCK.
5. ALL SIGNS MINIMUM 48" X 48", UNLESS OTHERWISE SPECIFIED.
6. CHANNELIZATION DEVICES ARE 28" REFLECTIVE CONES. SEE TABLE 1
FOR SPACING DISTANCES.
7. ALL SPACING MAY BE ADJUSTED TO ACCOMODATE AT -GRADE
INTERSECTIONS AND/OR DRIVEWAYS.
BUFFER DATA
LONGITUDINAL BUFFER SPACE = B
SPEED (MPH)
1 25
1 30
1 35
40
45
50
55
60
65
70
LENGTH (FEET)l
155
1 200
1 250
305
360
425
495
570
645
730
TRANSPORTABLE ATTENUATOR ROLL AHEAD DISTANCE = R
HOST VEHICLE WEIGHT
9,900 TO 22,000 LBS.
HOST VEHICLE WEIGHT
> 22,000 LBS.
< 45 MPH
45-55 MPHI
> 55 MPH
< 45 MPH
45-55 MPH
> 55 MPH
100' 1
123' 1
172'
74' 1
100' 1
150'
TABLE 1
CHANNELIZATION DEVICE
SPACING (FEET)
MPH
TAPER
TANGENT
50-70
40
80
35-45
30
60
25-30
20
40
•
CHANNELIZING DEVICE
i
PORTABLE SIGN AND SUPPORT
�®
WORK VEHICLE WITH FLASHING
LIGHT
WORK AREA
MINIMUM LANE CLOSURE TAPER LENGTH = L (FEET)
LANE WIDTH
POSTED SPEED (MPH)
(FEET)
25
30
35
40
451
50
55
60
65
70
10
105
150
205
270
450
500
550
-
-
-
11
115
165
225
295
495
550
605
660
-
-
12
125
180
245
320
540
600
660
720
780
840
T-MOBILE EDMONDS WAY - SE01632A
EF:DaoMD
1818 Rev.4/19
CONSTRUCTION OPERATIONS AND ENGINEERING REQUEST
TO
FROM
DATE
KEITH ELLSION
AZIZ HAQ 425-319-4209
12/21/21
ADDRESS/LOCATION/POLE NUMBER
9720 EDMONDS WAY EDMONDS, WA
// 36(27-3)NE // PLI: 157911
MAP NO.
ORDER NO. OPERATION NO.
474-G1
100088972 30
ACTION•
PLEASE ASSIST T-MOBILE WITH THE
MODIFICATION OF THEIR ANTENNA SITE
MOD INCLUDES REPLACING ALL POLE
MOUNTED EQUIPMENT AND INSTALLING NEW CABLING
ANTENNA TIP HEIGHT: 74.5' AGL
COORDINATE WITH KEITH ELWELL - 425-753-3458
EQUIPMENT WEIGHTS ON T-MOBILE DRAWING A-3:
- AHLOA RADIO:84 LBS.
- AHFIG RADIO: 80 LBS.
- AEHC ANTENNA: 108 LBS.
231 265034
- OCTO ANTENNA: 125 LBS.
�7 7
A-48905 C-1544
75-400949
801 E-52393 ___--------- 231
EDMONDSWY
ENGINEERING DIVISION
"'7TED
E'o 11-11-1
00
- 1
i 1 /21 /2022
o6_ FU40 FU40
_6
REVIEWED FOR TRAFFIC
CONTROL ONLY. SEE WIRELESS
2005 P 157911 -45130
ROW PERMIT ENG2021-0140
SW 12-4329 FU40 SL-112 268745
L 112086 H 2 57159 E 52378
SL-111803-H
RECEIVED
11-11-11/02
790-M
DEC 22 2021 14 0 231
1 9802-M 2
9720-M
w 1�
9 6-M9726
CITY OF EDMONDS
DEVELOPMENT N
SL-1
50-454705
SERVICES DEPARTMENT
37-13454
50 454707
NORTH
2O94 E Old
06`/5-454372 4
For de -energizing customer service for
Customer work CUSTOMER CREW HOURS
When completed, coil
the PUD at 425-783-1000
Customer Signature
or (1-877-783-1000) ask
Dote for Energy Control Dispatch
ACTIONOR
OTHER ACTIONREQUIRED
APPROVED BY
COMPLETED BY DATE
Distribution: White -Department Responsible For Work -Return To Originator When Completed Blue-GIS, 03, After Work Completion
Canary -Department Responsible For Work -File Copy Pink -Originator