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ENG2022-0443 ROW PERMITOF WAY EUC PERMIT o PERMIT NU City of Edmonds EdmondsRIGHT •:0 www.cityofedmonds.gov RL Description: PSE-INSTALL GAS SERVICE FOR SELECT SHORT PLAT PLN2021-0039 ISSUED: 10/13/2022 Address: 7918 203RD ST SW EDMONDS WA 98026-6853 EXPIRES: 04/13/2023 Permit Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 27041900112700 CONTACTS 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)516-4388 OWNER SELECT HOMES INC 8304 212TH ST SW, EDMONDS WA 98026 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. 7- INSPECTION SCHEDULING: WWW.MYBUILDING PERMIT.COM 24 HR NOTICE REQUIRED r 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 10/13/2022 RELEASED BY DATE Printed: Thursday, October 13, 2022 10:11:47 AM 1 of 2 oe e n,y RIGHT OF WAY EUC PERMIT sAd - City of Edmonds Edmonds 98020 CONDITIONS CONDITION TYPE NOTES 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 7:00am to 6:00pm on SOUND AND NOISE weekdays and 10:00am and 6:00pm 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 NOTES COMPLETE A-1 JOB START X-2 ENGINEERING FINAL" E-7 RESTOR LIMITS Printed: Thursday, October 13, 2022 10:11:47 AM 2 of 2 ofEOMotio� RECEIVED RIGHT OF WAY CONSTRUCTION SEP 12 2022 PERMIT APPLICATION ComComplete and submit this Application in accordance with the Submittal CITY OF EDMONDS P pp DEVELOPMENT /'Vc. is') 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 General • Project Name io6388977 Site Address or if no site address use Property Address at NW corner of project area: 7918 203rd 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.) install gas at approx 16' N to 3' N c/1 of 203rd ST SW & 914' W c/I of 77th AVE W (1) 3x5 grass cut & (1) 3x3 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 ❑ power Exgas ❑ 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: 08/31 /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 Job #: Date: Jurisdiction: ROW Permit: Est. Start Date: Est. Duration: Puget Sound Energy Gas Pre -Inspect Form 106388977 Service Address: 7918 203RD ST SW 8/17/22 City EDMONDS Zip: 98026 EDMONDS Customer: GARY KLICK Phone: 206-730-0670 Yes Customer Email: 10/24/22 PM / Inspector: Nayeli Torres -Garcia 2 Days (16 Hours) Site Contact Email: GARY KLICK Phone: (206) 556-5066 Phone: 206-730-0670 Job Description Project Scope: FROM 2" MPE MAIN ON 203RD ST SW, INSTALL APPROX. 126' OF 1-1/4" PE SVC (36'PLAT/90'SCAT) AND SET A250 MSA O/R New Construction: ON FRONT HOUSE. FROM NEW SVC, INSTALL APPROX. 76' OF 1-1/4" PE PLAT TWIN SVC AND SET A250 MSA O/R ON BACK HOUSE. Yes PLAT Map: 162.069 CM: KIRK SCHROEDER.............. ............. ............... :... Applicant shall repair/replace all 425-736-7041 OWNER/CONTRACTOR IS RESPONSIBLE FOR damage to utilities or frontage EROSION CONTROL AND DRAINAGE improvements in City right-of-way per city standards that is caused or OWNER/CONTRACTOR RESPONSIBLE FOR LOCATING occurs during the permitted project. ALL ON SITE UTILITIES. RELOCATION/REVISION TO ANY UTILITIES MAY REQUIRE A SEPERATE PERMIT. / . STORM WATER i... SEWER ............. :...... ..... — — — — — — — — — — — — — — — — — — — — — — i•••••••••••••a•••••• EXISTING 2" MPE IP 16'N 107006790-1999 i WATER PROPOSED 1-114" PE SVC AND TWIN SVC GAS SERVICE SHALL BE WITHIN EASEMENT I I I I I I 1 7918 7922 Construction Method Hole Hog Building Foundation Type Slab Septic System No t ENGINEERING DIVISION N ...'7TED _ 0/12/2022 ...... PARKING SHOULDER ............. .............................. .............: LW Work Location Size of Cut Surface Type 16' NORTH I of CL 1203RD ST SW & 914' WEST of CL 77TH AVE W 3 X 5 X 2 GRS 3' NORTH I of CL 1203RD ST SW & 914' WEST of CL 177TH AVE W 3 X 3 X 2 A Service Information Street Information Job Type Diameter: 1-1/4" PE Flaggers #: 0 Arterial: No New Residential Svc EFV: 1-1/4" - 2600 - 9996744 Police #: 0 TCP: Yes Tie -In Fitting Meter: A250 A250 Speed Limit: 30 No Parks #: 6 MDPE - 2" IPS - (DIA) 1-1/4"IPS 9999548 Meter Loc: 08 - OR Trolley Lines: No Mtr Hoods #: 0 Del Press: 6" W.C. Traffic Signal: I Bus Stop: No SNO YRD - Snohomish 0 Bollards: 2.5" # 4" # ADA Ramps #:1 0 Route #'s: RECEIVED SEP 12 2022 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT W20-7A Notes: 1. All signs and spacing to conform to the MUTCD and City of EDMONDS standards. 2. All sidewalks, driveways, exits and egresses shall be completely clear unless otherwise indicated. 3. Channelizing devices are 28" traffic cones. Use traffic drums (barrels) with steady burning Type C lights on all State State Routes and Hwys. 4. Sign size can be a minimum of 36" x 36" and shall not obstruct pedestrian access. 5. Crew is required to leave a minimum of 11' for traveling lane width. 6. Alert affected residents and businesses. 7. Work to take place between 9 a.m. and 4 p.m unless otherwise specified. All work for arterials and major roadways will be from 9 a.m. to 3 p.m. 8. Work area will be 167 T NCL of 203RD ST SW & 914' WCL of 77TH AVE W. CREW SHALL POTHOLE FOR WATER MAIN DEPTH PRIOR TO PROJECT START co C� • CD �J r 50' LEGEND ® 28" TRAFFIC CONE ® WORK PIT TRAFFIC FLOW FLAGGER WORK VEHICLE/ FLASHING LIGHTS SIGN LOCATION RIGHT OF WAY Row Row TEMPORARY TRAFFIC CONTROL PLAN 7918 SIGN SPACING MPH I.K. 60/65 1000, 45/55 500' 35/40 350' 30 200' 25 100' RESIDENT(S) WILL BE INFORMED OF POSSIBLE TEMPORARY DRIVEWAY CLOSURE V-0ZM dL-•OM ZJ ��-O ■Z0 W vao �ZM O¢_ ,00 '000Q C= 203RD ST SW 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 OWNER/CONTRACTOR RESPONSIBLE FOR LOCATING ALL ON SITE UTILITIES. RELOCATION/REVISION TO ANY UTILITIES MAY REQUIRE A SEPERATE PERMIT. CHANNELIZATION DEVICE SPACING MPH TAPER TANGENT 55/70 40 80 35/45 30 60 U25/30 20 40 ENGINEERING DIVISION "OTED p(� 0/12/2022 RECEIVED SEP 12 2022 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT Designer: PLAN PREPARED BY: REV PUGET TRAFFIC MANAGEMENT, INC. 08/26/2022 0 SOUND John Crofoot 800.763.3999 ENERGY 425-424-6658 www.trafficmanagement.com Job # Traffic Camel Services - Sales & Rentals Permits & Consulting Engineering Training TCP@PSE.COM TAAI 502656148 C31 # 785804 Project Address: TMI CONTACT PERSON: Michael Flanagan TGS 7918 203rd St, Edmonds, WA 98026 PLAN ORDER:71 96 Page PLAN ORDER: 74096 DATE: 8126122 1 OF 1