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POE New Admin-Maint Bldg. - ROW Permit Appof EV kloi/,_� RIGHT OF WAY CONSTRUCTION PERMIT APPLICATION Complete and submit this Application in accordance with the Submittal ''vc. isa° Requirements outlined in Right-of-Wa\- permit Handout E6�. If any field is not applicable to your project, N%Tite "N/A" instead of leaving blank. All fields required. Incomplete Applications will be denied. SECTION A General Info Project Name port of Edmonds Site Address or if no site address use Property Address at NW corner of project area: Associated Permits: IBLD 2 0 21-13 8 5 1 PLN ENG •applicable) Name of Company port of Edmonds Franchise Ordinance No: PointofContact Chris Osterman Title PA Address 471 Admiral Way city Edmonds state WA Zip 98020 Phone 425-673-2008 Email ap@portofedmonds.org OwnerContractor and Authorized Agent of Name of Company S ee West Construction Co. PrimaryName Ben Henderson Agent Name Doug Spee Title PM Title President Mobile 425-252-1500 Address 307 Bell St., Suite 101 Email bhenderson@speewest.com city Edmonds I State WA Zip 98020 Secondary Name Mike Linn Phone 206-284-7733 Title Superintendent Email dspee@speewest.com Mobile 206-719-8097 City of Edmonds Business License No: BL-004298 Email mlinn@speewest.com state License No: SPEEWCC101MF x Contractor verifies it is currently bonded x Contractor verifies it currently has general liability insurance NOTE: ECDC t8.6o.o2o requires that the Application be signed by a licensed and bonded contractor unless otherwise approved by the city engineer. DevelopmentType of ❑ Multifamily residential X 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 weln ❑ Traffic Control Only (no associated development) City of Edmonds ROW construction permit Application --Page i of 3 Updated 3/25/2021 ❑ Utility Franchise Work (no associated development) 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.) Construction of a new retail, office & maintenance shop within a building footprint of 6,650 SF. Revisions to existinq parking, relocation o an new par mg lot ig tinq, new landscaping, ROW r : Street tie-ins to sewer. water. and storm main lines Curb and au er Sidewalk Street trees Asphalt patch and overlay RIGHT-OF-WAY CLOSURE AREA TOTAL DURATION (Number of Months) Sidewalk 72 hours + 5 LF x 180 LF 900 SF 10 Alley 2 hours + LF x LF SF Parking 72 hours + LF x 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: X telecommunications X cable X power ❑ gas X water cx sewer X storm Details N'Vorj� be of to Compictcd 1. 1 Does the utility owner have existing overhead infrastructure in the area of work? Yes No X 2. 1 Will any equipment be added underground or above ground (e.g. 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 system? X 5. Does the work involve proposed additions to an aboveground utility system? 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 IN, o 6. 1Does your project involve rebuilding or replacing utility equipment which currently serves more than one lot or commercial development? I X City of Edmonds ROW construction permit Application --Page 2 of 3 Updated 3/25/2021 If yes, answer the following questions related to project area, i.e. the actual area in which the ro'ect is ro osed: X 6a. Does your project involve wires/cables/lines? If yes: New bored power, fiber, cable How many are existing? I I How many are to be added? 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? 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 licensed and bonded contractor; the information prow owner to act on its behalf and have aut Fees. The Applicant is responsible for APPLICANT SIGNATURE: der the laws of the State of Washington that: I am a in ' correct and complete; and I am authorized by to t application. DATE: 6/24/22 APPLICANT PRINTED NAME: APPLICANT TITLE: Douglas K. Spee President NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021