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ENG2022-0566 ROW PERMITRIGHT OF WAY EUC PERMIT PERMIT NUMBER City of • • . 98020 ENG2022-0566 www.edmondswa.gov i Description: PSE - CUT AND CAP UNUSED SERVICE WITH PAVEMENT CUTS ISSUED: 12/22/2022 Address: 838 FIR ST EDMONDS WA 98020-3903 EXPIRES: 06/20/2023 Permit Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 00619401201000 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 KENT M TTEE SCUDDER 838 FIR ST, EDMONDS WA 98020 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 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: GRN DATE: 12/22/2022 ENGINEERING DIVISION �.,7TED � GjI 2v 2/22/2022 Printed: Thursday, December 22, 2022 1:44:10 PM 1 of 2 RIGHT OF WAY EUC PERMIT PERMIT NU �!B E City of Edmonds ...121 Sth Ave N, Edmonds WA 9:01 1 .. www.edmondswa.gov • • 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 RESTOR LIMITS Printed: Thursday, December 22, 2022 1:44:10 PM 2 of 2 of EpM04O� /'V.isa° 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�. RECEIVED Nov 21 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 1o8639312 Site Address or if no site address use Property Address at NW corner of project area: 838 Fir St 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 INSingle 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.) Cut and cap idle stub at main work area is approx 40's c/1 of Fir St & 12' W c/l of C AVE S (1) 5x5 paving cut anticipated 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 ❑xgas ❑ 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: 11/17/22 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 PRE -INSPECTION REPORT Job #: 108639312 Date Received: 11/9/22 Address: 838 Fir St RECEIVED Jurisdiction: Edmonds / Snohmish City / Zip: Edmonds 98020 Nov 21 2022 Right of Way Permit? ❑ YES ❑ NO Cust Name: N/A DEVELOPMENT DSERV CES First POSs Start: Customer Email: DEPARTMENT First Poss Comp: PM / Insp: Tanya Martinson 425-417-0639 Job Description / Scope of Work: I I Est. Job Duration: NEW CONST.' ❑ YES ❑ NO SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM IFS / PSE Dig C&C Idle 5/8" PE stub at main. Service Work — No Stub Ftg: Ext Ftg: Tot Svc Ftg: 0' Main Ext Work — No PLAT MAP# 164.066 FIELD INSPECT-M.I.W.ON: BY: t OWNER/CONTRACTOR RESPONSIBLE FOR LOCATING N ALL ON SITE UTILITIES. RELOCATION/REVISION TO ANY UTILITIES MAY REQUIRE A SEPERATE PERMIT. ENGINEERING DIVISION APPROVED AS NOTED 0 OWNER/CONTRACTOR IS RESPONSIBLE FOR Power & Com ° EROSION CONTROL AND DRAINAGE 12/20/2022 Overhead 0 0 I I I I p—-------r�----I-- — — — ——----------- 0 I Fir St ° ' I I �o°e000ea°e°o°eo°ee�°oe c' S�1VN�eee�vpe� I eeeeoeeoeeeeveeeeeDee�Doe�� 1 ° I — — — — — — — — — — — — — — — — — — — — — — — 1�1�I — — — — r — — — — — — — —I — — — — — — — — — — — �\ \���I ° o eall Applicant shall reputilities damage to utilities or frontage 0 1 Utility patches shall be combined and full width or half ° ° improvements in City right-of-way _ _ _ _ _ ° _ _I I width overlay will be required depending on the extent per city standards that is caused or occurs during the permitted project. d I of disturbance. Where utility patches fall entirely within Q 1 one travel lane, the overlay shall extend to the 0 1 i centerline of roadway. Where utility patches extend into 0 0 W both travel lanes then a full width overlay is required. 0 WATER 14' S -------------------------0------L------r---------T-----------�--- I — — — STORMS — I;n 0 — — HYD ANT I 0 eeo'�ei°eeDaQooeeoeo DD 1 ° O C&C Idle stub �° I W I 8 V Q C.7 VQ @ main rn C)0 I I Q N ° � o I60' ROW I Work Location ' Size of Cut Surface Type 40'S of CL Fir St & 12' W of CL C Ave S 5x5 Asphalt of CL & of CL of CL & of CL ❑✓ FLAGGERS #: 2 25 MPH ❑ TROLLEY LINES ❑ BUS STOP #: ❑ METER HOODS M ❑ OFFICERS M SPEED LIMIT ❑ TRAFFIC ❑ ARTERIAL ❑ NO PARKS #: WORK TYPES P i p e S i z e EFV'S Meters Qty Pressure Misc Meter Stuff ❑ COMMERCIAL ❑ STUB ❑POTHOLE ❑ 1/2" ❑ 77$ ❑ 5/8" ❑ 250 ❑ Tempi Bar Size: ❑ EXTENSION ❑MAIN MAINT. ❑ 3/4" ❑ 1800 ❑ 6"WC ❑ RESIDENTIAL ❑ COMPLETE El11/8" ❑ 2600 ❑ 425_ ❑ 2# ❑BollardS 2.5" M ❑ ❑SERV MAINT. MULTI -FAMILY ❑ TWIN ❑ 11/4" ❑ 10,00 ❑ >_ ❑ 630 5# ❑Bollards 4" #: NEW CONST. El ALTER COMM SVC ❑VALVE MAINT. ❑ 2" 4�� ❑ N/A ❑ Fuel Line Permit ❑ ALTER RESID. SVC ❑LEAK REPAIR ❑ 6„ ❑ 1000 Fuel Line Length: 0 CUT & CAP ❑ SERVICE REPL. ❑CP WORK ❑ 8" Mtr LOC: I Fuel Line Diameter: