ENG2022-0530 ROW PERMIT�~ o� RIGHT OF WAY EUC PERMIT
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EdmondsCity of Edmonds PERMIT NU M
98020 1 1 1
www.edmondswa.gov i
Description: PUD - REPLACE 1 BO POLE
ISSUED: 11/14/2022
Address: 7124 208TH ST SW EDMONDS WA 98026-7244
EXPIRES: 05/14/2023
Permit Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 00380100000701
CONTACTS
NAME TYPE NAME ADDRESS PHONE
APPLICANT MOE NAVE PO BOX 1107, EVERETT WA 98206 (425)783-5681
CONTACT SNOHOMISH COUNTY PUD PO BOX 1107, EVERETT WA 98206-1107 (425)783-8262
CONTRACTOR SNOHOMISH COUNTY PUD PO BOX 1107, EVERETT WA 98206 (425)783-4353
OWNER ALFREDO CHANCCO 7124 208TH ST SW, EDMONDS WA 98026-7244
FEE INFORMATION
11
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.
RELEASED BY: MAJ DATE: 11/14/2022
Printed: Monday, November 14, 2022 3:46:34 PM 1 of 2
RIGHT PERMIT
PERMIT NUM
City of Edmonds
Edmonds WA 98020
www.edmondswa.gov / 425.1 1
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
E-7 TRAFFIC CTRL
X-2 ENGINEERING FINAL"
Printed: Monday, November 14, 2022 3:46:34 PM 2 of 2
WO# 100102636
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�.
OCT 28 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 130 Pole 10238
Site Address or if no site address use Property Address at NW corner of project area: 7124 208th St SW Edmonds, WA 98026
Associated Permits: BLD PLN ENG
Owner and Entity
Name of Company
Holding Franchise (if applicable)
Snohomish County PUD Franchise Ordinance No: N/A
Point of Contact
Andy Tran
Title
Design Engineer
Address
21014 63 rd Ave W
City
Lynnwood
State WA
Zip 98036
Phone
425-783-8262
Email
AXTran@snopud.com & 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 Same as above
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
V Contractor verifies it is currently bonded
�/ 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?
VOther, please specify: Maintenance
❑ 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.)
PUD to replace (1) BO pole as maintenance work. Pedestrian escort required. TCP included. Work not to exceed 72
hours. Tree trimming required. WesflaetH-A lane of 208th St SW to be closed. 4-8hr closure between
RAM_:t-RnPm Eastbound
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 u1power ❑ 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
V
No
2. Will any equipment be added underground or above ground (e.. pedestals, vaults, etc.)?
V
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:
V/
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
project is proposed:
6a.
Does your project involve wires/cables/lines? If yes:
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:
How many poles are existing in the project area?
See b
low in
What is the height of the existing poles?
6c.
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:
How many? 1 1 1 What is the height of the poles after? 35'
Describe the modification rebuild: PUD to replace (1) BO pole
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: '4M4 7u-4f, DATE: 10/28/2022
APPLICANT PRINTED NAME:
APPLICANT TITLE:
Andy Tran
Design Engineer
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021
0
pOFM PUBLIC UTILITY DISTRICT NO.1 OF SNOHOMISH COUNTY
LOCATION 7124 73RD AVE W EDMONDS, WA 98026 SOUTH COUNTY AREA
POLE NO. 10238 1/4S T R DATE 10/24/2022 ORDER 100102636
REASON FOR WORK PUD TO REPLACE BO POLE 10238 ENGINEER AXTRAN OPERATION 0030
DRAFTER U.G. NO.
SCALE 1"=60'
APPROVED
& DATE PRINTED
DATE WORK COMPLETED
FOREMAN
FEES REQ'D ❑ YES ■ NO
PRIMARY OVERHEAD
❑ RESIDENTIAL
❑ COMMERCIAL
LEO NO.
@$ _$
SECONDARY OVERHEAD
BASIC FEE S
METER/CONV.POLE $
PRIMARY UNDERGROUND
❑ RESIDENTIAL
❑ COMMERCIAL
BASIC FEE
LEU NO.
@$ '=$
SECONDARY UNDERGROUND
BASIC FEE 3
UNDERGROUND PLAT
BASIC FEE S
rL FT.@$ '=$
STREET LIGHTING
(� FT.@$ '=$
WORK IN RIGHT OF WAY
❑ PRIMARY
❑ SECONDARY
(� FT.@$ '=$
MISCELLANEOUS FEES
VAULT 3
PERMIT S
TOTAL DUE S
DATE PAID
RECEIPT NO.
SERVICE ORDER NO.
I FC,FNn:
NESC VIOLATIONS
■ NO ❑ YES (SEE NOTES)
PERMITS (DATE GRANTED)
❑ TREE TRIM
❑ STATE
❑ COUNTY
■ CITY
EASEMENTS
❑ REQUIRED ■ NOT REQUIRED
DATE RELEASED
FOREIGN CONTACTS
❑ JPN#
❑ JOINT TRENCH ZIPLY & CATV
❑ JOINT BORE ZIPLY & CATV
■ N/A
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 OC M&R
GIS Ph JOINT USE
LOCATION MAP PAGE 455 B6
O EXISTING POLE
X EXISTING POLE -TO BE REMOVED
• NEW POLE
NEW POLE TO REPLACE EXISTING POLE
DATE
SUBSTATION ESP
CIRCUIT NO. 12-688 PHASE 321
ENGR'S TEL. #
425-783-8262
ENGR'S CELL #
425-359-1123
VICINITY MOP
TRANSFER OF UTILITIES, REMOVAL OF POLE AND FINAL RESTORATION TO BE CONSISTENT
WITH APPLICABLE POLE ATTACHMENT AGREEMENT(S) AND JOINT OWNERSHIP POLE AGREEMENT.
OPLI# 10238, NEW PLI#_____ _
SET 35' CL2 POLE (PW2035, N0110), 1' SW
SET DEPTH = (5.5)'
USE 5/8" GRVL BCKFLL, CMPCT IN 6" LIFTS
XFR OH SVCS.
REMOVE OLD 35'POLE.
SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM
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TREE
TRIMMING TO CLEAR VEGETATION
AND TREE
BRANCHES 5'AROUND POLE FOR
CREW
TO REMOVE AND REPLACE POLE
I' WEST OF
EXISTING.
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.
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.
ENGINEERING DIVISION
APPROVED AS NOTED
,1,11 t�Q 11/10/2022
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RECEIVED
OCT 28 2022
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
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BETWEEN 8AM-3:30PM
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OCT 28 2022
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AHEAD
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CITY OF EDMONDS
ROAD
DEVELOPMENT
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SERVICES DEPARTMENT
AHEAD
W20-1
SNOHOMISH COUNTY
ERFOM
TRAFFIC CONTROL PLAN
PUBLIC UTILITY DISTRICT NO 1
BO Pole 10238 SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM
PROJECT
LOCATION 7124 208TH ST SW EDMONDS, WA 98026
ENGINEER ANDY TRAN DATE 10/25/2022
ORDER 100102636
PHONE 425-783-8262
CELLULAR 425-359-1123
RECEIVED
OCT 28 2022
CITY OF EDMONDS M BuildingPermit.com
CITY OF EDMONDS
Right -of -Way Application #1222520 - WO 100102636 - BO Pole 1023&RVICESLOIMENT 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 (425) 783-5681
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
7124 208TH ST SW
City Zip Code County Parcel Number
EDMONDS 98026 00380100000701
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
Alfredo Chancco
Number Street Apartment or Suite Number
7124 208TH ST SW
City State Zip
EDMONDS WA 98026-7244
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: 10/28/2022 Submitted By: Moe Nave
Page 1 of 2
i
CITY OF EDMONDS MyBuildingPermit.com
Right -of -Way Application #1222520 - WO 100102636 - BO Pole 10238
Project Contact
Company Name: Snohomish County PUD
Name: Andy Tran Email: jointuse@snopud.com
Address: PO Box 1107 Phone #: (425) 783-8262
Everett WA 98206-1107
Project Type Activity Type Scope of Work
Utility Purveyor Utility Work Disturbance of Surface
Project Name: WO 100102636 - BO Pole 10238
Description of PUD to replace 1 BO pole as maintenance work. Pedestrian escort required. TCP included.
Work: Work not to exceed 72 hours. Tree trimming required/included. Eastbound lane of 208th to
be closed. 4-8 hour closure between 8am-3:30pm.
Project Details
Project Information
Job Number
WO 100102636
Page 2 of 2