ENG2022-0162 ROW PERMITOF WAY EUC PERMIT
PERMIT NUMBER
City of Edmonds
EdmondsRIGHT
•:• • 1 1
www.cityofedmonds.gov• •
Description: PUD - REMOVE 1 BO POLE ISSUED: 05/10/2022
Address: 8606 238TH ST SW EDMONDS WA 98026-8940
EXPIRES: 11/10/2022
rmit Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 00463301000100
I 11-14111 a i
i
NAME TYPE NAME ADDRESS PHONE
APPLICANT MOE NAVE PO BOX 1107, EVERETT WA 98206 (425)783-5681
CONTACT PUD PO BOX 1107, EVERETT WA 98206 (425)512-3526
CONTRACTOR SNOHOMISH COUNTY PUD P.O. BOX 1107, EVERETT WA 98206 (425)670-3216
OWNER RIANA & POTVIN RYAN GIUSTI 8606 238TH ST SW, EDMONDS WA 98026
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE CHARGED PER PERMIT
$40.00 $40.00
RIGHT OF WAY STANDARD - EUC PERMIT FEE
$330.00 $330.00
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
05/10/2022
RELEASED BY
DATE
Printed: Tuesday, May 10, 2022 8:54:10 AM 1 of 2
-KRWOF WAY EUC PERMIT
City of Edmonds
•:• • 1 1 ..
. -. ov/425.771.0220
CONDITIONS
CONDITION TYPE
ALERT RESIDENTS
ALERT AFFECTED RESIDENTS AND OR BUSINESSES PRIOR TO WORK START.
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.
MAINTAIN EROSION AND SEDIMENTATION CONTROL PER CITY AND SWMMW STANDARD
ESC REQUIREMENTS
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.
SCHEDULE REQUIRED INSPECTIONS AS NOTED THROUGH MY BUILDING PERMIT.
INSPECTIONS
www.mybuildingpermit.com
POTHOLING
VERIFY CLEAR BORE CROSSINGS.
RESTORE LANDSCAPE
Restore landscape to like or better conditions
Sound or 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 AND 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 and activities must comply with the noise
limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120.
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**
Printed: Tuesday, May 10, 2022 8:54:10 AM 2 of 2
of EOMotio� RECEIVED
RIGHT OF WAY CONSTRUCTION APR 13 2022
PERMIT APPLICATION
Complete and submit this Application in accordance with the Submittal CITY OF EDMONDS
zDEVELOPMENT
/'Vc. i s')3 Requirements outlined in Right -of -Way permit Handout E6�. 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
WO 100093173
General •
Project Name Replace (i) B/O Pole
Site Address or if no site address use Property Address at NW corner of project area: 86o6 238th St SW, Edmonds WA
Associated Permits: BLD PLN ENG
Owner and Entity Holding Franchise (if applicable)
Name of Company Snohomish County PUD #1 Franchise Ordinance No: N/A
Point of Contact Andrea Nelson
Title Lead Designer
Address P.O. Box 1107
City Everett
State WA
Zip 982o6
Phone 425-512-3526
Email ajnelson@snopud.com and jointuse@snopud.com
Contractor and Authorized Agent of Owner
Name of Company SAME
(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
EN Contractor verifies it is currently bonded
Clc Contractor verifies it currently has general liability insurance
NOTE: ECDC18.6o.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
❑ Traffic Control Only (no associated development)
ixUtility 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.)
Replace (i) Depreciated pole at 86o6 238th St SW, Edmonds.
Needs Tree Trimming
Strip, Top and Enforce pole attachement agreement
Communications on pole is Comcast & Ziply
Replacement should take 6-8 hours- done in 1 day
RIGHT-OF-WAY
CLOSURE
AREA
TOTAL
DURATION
(Number of Months)
Sidewalk 72 hours +
LF
x
LF
SF
no
Alley 72 hours +
LF
x
LF
SF
no
Parking 72 hours +
LF
x
LF
SF
no
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 ffpower ❑ 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?
X
4.
Does the work involve rebuilding or relocating an existing aboveground utility system which
connects a lot or commercial development to an existingunderground common utilitystem?
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?
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? 1 1 1 How many are to be added? o
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? 45'
How many poles are to be removed? 1
Are additional poles to be laced? o
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? 1 1 1 What is the height of the poles after? same
Describe the modification rebuild: replace existing with same type and height
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: Andrea Nelson DATE: 4/12/22
APPLICANT PRINTED NAME: Andrea Nelson
APPLICANT TITLE: Lead Designer
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
O PUBLIC UTILITY DISTRICT NO.1 OF SNOHOMISH COUNTY
LOCATION 8606 238TH ST SW, EDMONDS LYNNWOODAREA
POLE NO. 15288 SW1/4S 31 T 27 R 4 DATE 3/17/22 ORDER 100093173
REASON FOR WORK REPLACE BO POLE ENGINEER A,NELSON OPERATION 0030
DRAFTER U.G. NO.
SCALE 1"=100'
APPROVED
& DATE PRINTED
DATE WORK COMPLETED
FOREMAN
FEES REO'D ❑ YES ■ NO
PRIMARY OVERHEAD
❑ RESIDENTIAL
❑ COMMERCIAL
LEO NO.
SECONDARY OVERHEAD
BASIC FEE S
METER/CONV.POLE s
PRIMARY UNDERGROUND
❑ RESIDENTIAL
❑ COMMERCIAL
BASIC FEE S
LEU NO
'@$
=$
SECONDARY UNDERGROUND
BASIC FEE
S
UNDERGROUND PLAT
BASIC FEE
S
FT.@$ '=$
STREET LIGHTING
FT.0 '=$
WORK IN RIGHT OF WAY
❑ PRIMARY
❑ SECONDARY
(� FT.0 '=$
MISCELLANEOUS FEES
VAULT
S
PERMIT
S
TOTAL DUE S
DATE PAID
RECEPT NO.
SERVICE ORDER NO.
NESC VIOLATIONS
■ NO ❑ YES (SEE NOTES)
PERMITS (DATE GRANTED)
❑ TREE TRIM
❑ STATE
❑ COUNTY
■ CITY EDMONDS
EASEMENTS
❑ REQUIRED ■ NOT REQUIRED
DATE RELEASED
FOREIGN CONTACTS
■ JPN#
❑ JOINT TRENCH ZIPLY & CATV
❑ JOINT BORE ZIPLY & CATV
El
POLE STENCILING
FROM TO
TAKE OFF POLE
PRE-CONST. REQUIRMENTS
■ TREE TRIM ❑PUD LOCATOR
❑ BACKHOE ❑ FLAGGING
■ ONE CALL DATE
No.
STREET LIGHTING
❑ YES ■ NO
M&R AS -BUILT
GIS
GIS QC M&R
GIS Ph JOINT USE
LOCATION MAP PAGE 474 J-2
LEGEND:
o EXISTING POLE
X EXISTING POLE -TO BE REMOVED
• NEW POLE
X NEW POLE TO REPLACE EXISTING POLE
DATE 3/24/2022
SUBSTATION RPK
CIRCUIT NO. 12-5217 PHASE 3
ENGR'S TEL. #
ENGR'S CELL #
425-512-3526
❑3
1 37
25
OWNER/CONTRACTOR RESPONSIBLE FOR LOCATING
ALL ON SITE UTILITIES. RELOCATION/REVISION TO ANY
UTILITIES MAY REQUIRE A SEPERATE PERMIT.
OWNER/CONTRACTOR IS RESPONSIBLE FOR
EROSION CONTROL AND DRAINAGE
ENGINEERING DIVISION
APPROVED AS NOTED
JX LVI gx,,.,4 ►,e 05/09/2022
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.
SL-131625-H
0 15-308896 T 1-375092 SL-131693-H
15285 FU65 233594 233593
238TH ST SVV
15288/O
15-1058
11/14
D
Q
=
8614 M 606
? 75-457660
A-6065
11822
8614
37-456155 25-3719
=131665-H SL 0502-A
828 23829
TO RPK
CKT 12-5217
SL-131666-H
37-374095
FU25
8506
5 3 25-23976
-18735
8506
823
AO POLE PL I # 15288
SET 45' CL 2 POLE (PW2045, N0110), TIGHT SOUTH
FRAME (12V111) 1 PHASE VERT DBL DE
XFR 15 KVA OH XFMR (12V601)
UTC # 15-10586
SER#---------------
XFR OH SVCS
STRIP, TOP & ENFORCE POLE ATTACHMENT AGREEMENT
RECEIVED
- PUD TO ENFORCE POLE ATTACHMENT
AGREEMENT.
- PUD IS RESPONSIBLE FOR ENSURING THAT THE
OLD POLES IS REMOVED. CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
APR 13 2022
SHEET 1 OF 1
LANE
CLOSURE ON A
LOW VOLUME ROAD
(NO FLAGGER,
TRAFFIC SELF-REGULATING,
35 MPH OR LESS)
238TH
ST SW
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i ROAD W20-4
AHEAD
X
ROAD
i WORK W20-1
AHEAD
SNOHOMISH COUNTY
TIMM
TRAFFIC
CONTROL PLAN
PUBLIC UTILITY DISTRICT NO 1
PROJECT REPLACE BO POLE
LOCATION 8606 238TH ST
SW, EDMONDS
ENGINEER ANDREA NELSON
DATE 4/12/22 ORDER 100093173
PHONE
CELLULAR 425-512-3526
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ENGINEERING DIVISION
APPROVED AS NOTED
jill ".til rt,44.Q. 05/09/2022
vv
RECEIVED
APR 13 2022
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
RECEIVED
CITY OF EDMONDS
Right -of -Way Application #1124031 - WO 100093173
APR 13 2022
MyBuildingPermit.com
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
Applicant
First Name Last Name Company Name
Moe Nave Snohomish County PUD
Number Street Apartment or Suite Number E-mail Address
PO Box 1107 jointuse@snopud.com
City State Zip Phone Number Extension
Everett WA 98206 4257835681
Contractor
Company Name
Owner
Number Street Apartment or Suite Number
City State Zip Phone Number Extension
State License Number License Expiration Date UBI # E-mail Address
Project Location
Number Street Floor Number Suite or Room Number
8606 238TH ST SW
City Zip Code County Parcel Number
EDMONDS 98026 00463301000100
Associated Building Permit Number Tenant Name
Additional Information (i.e. equipment location or special instructions)_
Work Location
Property Owner
First Name Last Name or Company Name
Riana & Potvin Ryan Giusti
Number Street Apartment or Suite Number
8606 238TH ST SW
City State Zip
EDMONDS WA 98026
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: 4/13/2022 Submitted By: Moe Nave
Page 1 of 2
i
CITY OF EDMONDS MyBuildingPermit.com
Right -of -Way Application #1124031 - WO 100093173
Project Contact
Company Name: PUD
Name: Andrea Nelson Email: ajnelson@snopud.com
Address: PO Box 1107 Phone #: 425-512-3526
Everett WA 98206
Project Type
Utility Purveyor
Activity Type
Utility Work
Scope of Work
Disturbance of Surface
Project Name: WO 100093173
Description of Work: PUD to replace one BO pole. Attachers on pole are Comcast and Ziply. Replacement
should take 6-8 hours over course of 1 day. No tree trimming required.
Project Details
Project Information
Job Number
WO 100093173
Page 2 of 2