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ENG2022-0276 ROW PERMITOF WAY EUC PERMIT PERMIT NUMBER City of Edmonds EdmondsRIGHT 98020 1 1 www.cityofedmonds.gov Description: PSE - PERFORM ANNUAL INSPECTION AT TEST LEAD WIRE BOX ISSUED: 08/02/2022 Address: 7212 220TH ST SW EDMONDS WA 98026-8014 EXPIRES: 02/02/2023 rmit Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 27042900301800 i NAME TYPE NAME ADDRESS PHONE APPLICANT SUSAN SIDICK 1660 PARK LANE, BURLINGTON WA 98233 (425)457-6353 CONTACT PUGET SOUND ENERGY- CORROSION 1660 PARK LANE, BURLINGTON WA 98233 (425)457-6353 DEPARTMENT CONTRACTOR PSE/INFRASOURCE 1660 PARK LANE, BURLINGTON WA 98233 (425)457-6353 OWNER EDMONDS VILLAGE LLC 1000 2ND AVE 3230, SEATTLE WA 98104 FEE INFORMATION DESCRIPTION AMOUNT PAID CITY TECHNOLOGY FEE CHARGED PER PERMIT $40.00 $40.00 ENGINEERING INSPECTION FEE $110.00 $110.00 RIGHT OF WAY STANDARD - EUC PERMIT FEE $330.00 $330.00 REQUIREMENTS 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 J. 08/02/2022 RELEASED BY DATE Printed: Tuesday, August 02, 2022 2:24:48 PM 1 of 2 -KRWOF WAY EUC PERMIT ER City of Edmonds •:• •ENG2022-0276 www.cityofedmonds. 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** E-7 TRAFFIC CTRL Printed: Tuesday, August 02, 2022 2:24:48 PM 2 of 2 RECEIVED of EpM04O� SECTION A RIGHT OF WAY CONSTRUCTION PERMIT APPLICATION Complete and submit this Application in accordance with the Submittal Requirements outlined in Right-of-Wgy permit Handout E6�. Jun 06 2022 CITY OF EDMONDS 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. General • Project Name 887033545 Site Address or if no site address use Property Address at NW corner of project area: 7212 220 ST SW 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 ❑ 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) ❑ 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.) Perform yearly inspection for TS-034202 at test lead wire box Location: 26' Sc1220 St SW & 57' Ecl HWY 99 Duration approx. 15 min 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 1 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 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? 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: o6/03/22 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 PUGET SOUND ENERGYcONSTRUCTION HOURS LEGENDS PROJECT LOCATED AT LIMITED TO 9 AM TO 3------- --- 26' Scl 220th ST SW & 57' Ecl Hwy 99 PM MONDAY - FRIDAY, TRAFFIC Mountlake Terrace, WA 98026 10 AM TO 6 PM DIRECTION DURATION OF WORK SATURDAY, NO SUNDAY APPROXIMATELY 15 MINUTES OR FEDERAL HOLIDAY TEM .TRAFFIC HOURS OF OPERATION DIRECTION M-F, 9AM-4PM 3 PM ��a CHANNELIZING fit, CONTACT WSDOT 48-72 HRS DEVICE BE7-Y FRANK PRIOR TO START OF WORK. ADVANCE WARNING Engineering Assistant CONTACT BONIE NAU " SIGN LOCATION Puget Sound Energy 206-440-4471 Corrosion Protection Dept. T-19L 28" TRAFFIC Cell # 206-396-9244 CONES Email: b frank@pse.com TS-034202 N s NOT TO SCALE TRAFFIC CONTROL PLAN #1 OF 1 WORK IN INTERSECTION REASON, PREFORM YEARLY READ AT TEST LEAD WIRE BOX G20-2 220TH ST SW I I G OWNER/CONTRACTOR IS RESPONSIBLE FOR I EROSION CONTROLAND DRAINAGE ATTACH SIGN 165' SEQUENCE (A) TAPER Applicant shall repair/replace all damage to utilities or frontage improvements in City right-of-way per city standards that is caused or S I G N SEQUENCE A SPACING TABLE occurs during the permitted project. " I. " X 200'K- X X X ROAD WORK AHEAD ACTIVITY 100, / / / AREA TANGENT 100' CHANN✓;LIZING DEVICES SPACING ( FEET ) MPH I TAPER TANGENT 20/301 20 1 40 RIGHT LANE W20-1 CLOSED W4-2L AHEAD W20-5R NOTES: 1. MAINTAIN A MINIMUM OF ONE ACCESS POINT FOR EACH BUSINESS WITHIN WORK AREA LIMITS. 2. ALERT METRO TRANSIT PRIOR START OF WORK, RECEIVED Jun 06 2022 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT TANGENT 165' T-19L TAPER / LIGHTED ARROW ATTACH SIGN "i BOARD REQUIRED SEQUENCE (A) ON HWY 99 ENGINEERING DIVISION TRAFFIC CONTROL SERVICES r 1 )TED FELIPE J. MACIAS, TCS #002689 itirkrcRtra�cconirolsarvices net OFFICE # (425) 656.3656 17/255/2022 NOVEMBER 24, 2014 F S 220 St SW & Hwy-99 Job# 887033545 / TS-034202 Location: 2611 Scl 220 St SW & 5711 Ecl Hwy-99 Work Description: Perform yearly maintenance and get read • test lead wire box t ` Excavation : No digging or cutting Lane Closure: 1 Eastbound lane of 220 St SW 4 Duration: 15 mins -_CD OWL— SOUTH RECEIVED Jun 06 2022 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT E A S T OFF DUTY DETAIL INFORMATION SHEET EDMONDS POLICE OFFICERS ASSOCIATION 250 5T" AVE N, EDMONDS, WA 98020 The purpose of this sheet is to provide information regarding the requesting of; cost of; and procedures for scheduling Police Officers for'off-duty' details within the City of Edmonds. Point of Contact: • Officer Jason Shier, EPOA Vice President: o Email: vicepresident.epoa@gmai1.com. o Cellular phone: 206-353-2987 Requesting an officer: (Please request an officer with as much advance notice as possible!) • To schedule an officer, please email Officer Jason Shier at vicepresident.epoa@gmail.com. Please include your company name, Point of Contact (name, phone number, and email), location of the detail, date(s) and time(s) of detail, and a brief description of what officer will be doing (i.e. directing traffic, closing a traffic lane, providing security, etc). • Additionally, if your Point of Contact is NOT the same person to whom the invoice is to be sent, please include the 'Finance Person's': name, email address, and phone number. NOTE: Oficer Shier works a rotating schedule, so to insure that your detail request is received and reviewed in a timely manner, it is recommended that you call his cell phone in addition to sendina the email. Rate of Pay: (NOTE: Minimum of 4 hours will be paid to the officer) • Requests made 7 or more days in advance: The rate of pay for an officer working an off - duty detail will be $75 per hour. • Requests made less than 7 days in advance: The rate of pay for an officer working and off -duty detail will be $80 per hour. 1 Effective: May 24, 2018 OFF DUTY DETAIL INFORMATION SHEET • Details that fall on a holiday will be paid at an additional $30 per hour ($105 per hour with 7 or more days notice/$110 per hour if less than 7 days notice). List of Holidays: New Year's Day (January 1) Washington's Birthday (Third Monday of February) Independence Day (July 4) Veteran's Day (November 11) Friday following Thanksgiving Day Martin Luther King Day (Third Monday of January) Memorial Day (Last Monday of May) Labor Day (First Monday of September) Thanksgiving Day (Fourth Thursday of November) Christmas Eve (December 24) Christmas Day (December 25) New Year's Eve (December 31) Cancellations: (Note: date and time of cancellation will be based on the date and time of the phone call, not email.) • To cancel an officer, you MUST call Officer Shier at 206-353-2987. Additionally, please follow up the phone call with an email to vicepresident.epoa@gmaii.com requesting the cancellation If you cancel an officer more than 24 hours before the start of the detail, you will not be charged for the cancelled detail. • If you cancel an officer less than 12 hours prior to the start of the detail, you will be charged for the '4 hour minimum'. • Administrative fees will still be charged for all details, regardless of when they are cancelled. Payment Deadlines: • If you do not require an invoice, officers are to be paid via check or cash at the start of the event. (check made payable directly to the individual officer(s). • If you require an invoice, officers should be paid within two weeks of invoice being emailed to your Point of Contact (or Finance if provided). • Delays in paying officers may result in difficulty obtaining officers for future details. 2 Effective: May 24, 2018