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ENG2023-0102 ROW PERMITRIGHT PERMIT • M. City •Edmonds 121 5th Ave N, Edmonds 9802001 www.edmondswa.gov / 425.1 1 Description: COMCAST - MAINTENANCE SPLICE AT 723 15TH ST SW ISSUED: 03/10/2023 Address: 723 15TH ST SW EDMONDS WA 98020-5119 EXPIRES: 09/10/2023 Permit Type: RIGHT OF WAY EUC Permit Subtype: MINOR Parcel Number: 00390000000800 CONTACTS NAME TYPE NAME ADDRESS PHONE APPLICANT LEAH IHLENFELDT 19910 NORTHCREEK PARKWAY N, BOTHELL WA 98011 (360)670-4291 CONTACT CABLECOM LLC 19910 NORTHCREEK PARKWAY N, BOTHELL WA 98011 (360)670-4291 CONTRACTOR CABLECOM LLC 1316 BONNEVILLE AVE, BLDG A, SNOHOMISH WA 98290 (360)668-1300 OWNER EVELYN ANDERSON 723 15TH ST SW, EDMONDS WA 98020-5119 FEE INFORMATION DESCRIPTION AMOUNT PAID CITY TECHNOLOGY FEE CHARGED PER PERMIT $40.00 $40.00 RIGHT OF WAY MINOR - EUC PERMIT FEE $110.00 $110.00 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. 94 RELEASED BY: MAJ DATE: 03/10/2023 Printed: Friday, March 10, 2023 1:56:03 PM 1 of 2 RIGHT PERMIT 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 X-2 ENGINEERING FINAL" Printed: Friday, March 10, 2023 1:56:03 PM 2 of 2 RECEIVED OF Wkto�l> INC. 1 S9 0 SECTION A RIGHT OF WAY CONSTRUCTION PERMIT APPLICATION Complete and submit this Application in accordance with the Submittal Requirements outlined in Right -of -Way permit Handout E63. FEB 23 2023 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 COM CAST - JB0001271303 Site Address or if no site address use Property Address at NW corner of project area: 723 15TH ST SW E DM ON DS WA 98020 Associated Permits: BLD 7 PLN ENG Owner and Entity Holding• .•- Name of CompanyCOMCAST CABLE HOLDING Franchise Ordinance No: Point of Contact OWEN SHACKETT Title PERMIT COORDINATOR Address410 VALLEY AVE NW City PUYALLUP State WA Zip 98371 Phone253-341-9318 EmailOWEN SHACKETT@CABLE.COMCAST.COM Contractor• -• Agent of •wner (see note •- •w) Name of CompanyCABLECOM LLC Contractor ContactsDuring Construction Primary Name CABLECOM LLC - MICHAEL FINCH Agent Name SUNSHINE CRABBS Title CONSTRUCTION SUPERVISOR Title PERMIT COORDINATOR Mobile 360-965-5085 Address19910 NORTHCREEK PARKWAY NORTH, SUITE 100 EmailMICHAEL.FINCH@CABLECOMLLC.NET City BOTHELL State WA Zip 98011 Secondary Name Phone 360-454-3163 Title Email SUNSHINE.CRABBS@CABLECOMLLC. NET Mobile City of Edmonds Business License No: N R - 021818 Email State License No: CABLEL'971 DP j6 Contractor verifies it is currently bonded Contractor verifies it currently has general liability insurance NOTE: ECDC 18.6o.02o 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 well) ❑ Traffic Control Only (no associated development) City of Edmonds ROW construction permit Application --Page i of 3 Updated 3/25/2021 Vbtility Franchise Work (no associated development) Project Description 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.) MAINTENANCE SPLICES AT EXISTING AERIAL AND GROUND CASES AT THE FOLLOWING LOCATIONS:7 723 15TH ST SW F 823 ELM WAY, 1211 8T 1136 8TH AVE S, 639 ELM ST, 1229 7TH AVE S 1 CORONADO PL, 22003 100TH AVE W, 22047 98TH PL W, 728 13TH WAY_-,W SW, , 227TH PL SW, 22717 98TH AVE W,723 15TH ST SW PERMIT VALID FOR SINGLE LOCATION ONLY RIGHT-OF-WAY CLOSURE AREA TOTAL DURATION (Number of Months) Sidewalk 72 hours + LF JxJ LF SF Alley 72 hours + LF JxJ F SF Parking 72 hours + LF JxJ 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 16 cable ❑ power ❑ gas ❑ water ❑ sewer ❑ storm Details of Work to be Completed 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? X Are the additions for the purpose of serving a single-family residential subdivision? X Details of • 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 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 project is proposed: X 6a. Does your project involve wires/cables/lines? If yes: �/ /� How man are existing? How man are to be added? 6b. Does your project involve poles? If yes: 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: 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: 5u 411.1 C 4C�6 DATE: 02/21/2023 APPLICANT PRINTED NAME: Sunshine Crabbs APPLICANT TITLE: PERMIT COORDINATOR NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021 Right of Way Completed By: COURTNEY MITCHELL Address: 841 ELM WAY EDMONDS WA98020 Completion Date: 2/21/2023 Right of Way Footages: O M C A S T C I Job Type: Select New Aerial Coax: 0 Overlash Coax: 0 New UG Fiber: 0 New Aerial Fiber: 0 Overlash Fiber: 0 Existing UG Fiber: 0 Empty Conduit Only: 0 New UG Coax: 0 Existing UG Coax: 0 Are Additional Pages Needed: No Job Subtype: Select Survey Scope: Post -Sale Project Manager: Select Source System: JB0001271303 Legend New Ped New Vault Existing U/G Existing Aerial New U/G New Aerial Interior Path Exterior Building Path Footage Break Fiber Splice Point Storage Loop Riser Pole Lock Box Footage Text Box Callout Arrow New Tap Phase Identifier Power Suppy Hard Surface Cut Abandoned Cable 0 0 150' Text ❑1 PS 0 Provide Clear Construction Details MAINTENANCE SPLICES AT EXISTING AERIAL LOCATION :723 15TH ST SW NO NEW CONSTRUCTION SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM 13th Way SW co JQ, �I 3 1 I 1 to 27. 723 15TH STSW AERIAL 27 H 226th St SW 226th PI SW ------------- Birch St I lsU� St SW 14th St SW a a* .,r A O� 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. I SW ENGINEERING DIVISION APPROVED AS NOTED Jill LVI,,10,4at 03/09/2023 VV RECEIVED FEB 23 2023 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT Route Overview Completed By: COURTNEY MITCHELL N W p., E Completion Date: 2/21/2023 Address: 841 ELM WAY EDMONDS WA 98020 C O! • i ICA S T Job Type: Select` Job Subtype: Select Footages Entered On Right of Way, Private Exterior, and Private Interior tabs. Footages are summarized on Survey Rollup tab. Survey Scope: Post -Sale Project Manager: Are Additional Pages Needed: No Select Source System: JB0001271303 *IMPORTANT CONSIDERATIONS FOR ROUTE OVERVIEW COMPLETION* NOTE ALL FUTURE PEDESTAL / VAULT LOCATIONS ENSURE YOU HAVE VERIFIED THE EXISTING COMCAST FACILITIES (FIBER / CASE LOCATIONS / SHEATHS PER CASE / SLACK LOCATIONS / FOOTAGE / STRUCTURE) SHOWN ON THE FACILITY SEARCH MAP WITHIN THE CONSTRUCTION AREA. SHOW ENTIRE ROUTE FROM TIE IN TO CUSTOMER LOCATION Legend Provide Clear Construction Details MAINTENANCE SPLICES AT EXISTING AERIAL LOCATION :723 15TH ST SW New Ped ❑ NO NEW CONSTRUCTION New Vault ❑V Existing U/G Existing Aerial New U/G New Aerial JLInterior t— Path Exterior Building Path tiEdmonds r, - ' WA Footage Break `.t \ 1 1 u V1, •t r cam' _ ? I Fiber Splice Point _ _ v •J. 1 L Storage Loop 21 v A Riser Pole I moo` [y � j ""'�• - - � I •" � I ' ! �.��5ts�� Lock Box Footage 15o' 1a. I u _ 9 1 I Y ?q J _ t 4 r N � � i Text 1 0` = _. , v . � � Text Box _. ...v .•+ t Roby tLaatyPsk- Callout Arrow New Tap 0 Phase Identifier Power SuPPY ' Hard Surface Cut F .v RECEIVED FEB 23 2023 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT TRAFFIC CONTROL Completed By: COURTNEY MITCHELL Address: 72315TH ST SW EDMONDS WA98020 Completion Date: 2/21/2023 Private Exterior Footages: COMICAST Job Type: Select New Aerial Coax: 0 Overlash Coax: 0 New UG Fiber: 0 New Aerial Fiber: 0 Overlash Fiber: 0 Existing UG Fiber: 0 Empty Conduit Only: 0 New UG Coax: 0 Existing UG Coax: 0 Are Additional Pages Needed: No Job Subtype: Select Survey Scope: Post -Sale Project Manager: Select Source System: JB0001271303 Legend Provide Clear Construction Details MAINTENANCE SPLICES AT EXISTING AERIAL AND GROUND CASES AT THE FOLLOWING LOCATIONS: 1229 7TH AVE S, 1227 8TH AVE S, 1239 CORONADO PL, 22003 100TH AVE W, 22047 98TH PL W, 728 13TH WAY SW, 706 13TH WAY SW, 22509 98TH AVE W, 9723 227TH PL SW, 22717 98TH AVE W NO NEW CONSTRUCTION, ALL EXISTING CASES. New Ped ❑ New Vault ❑V Existing U/G Existing Aerial NewU/G New Aerial ----- Interior Path ----- Exterior Building Path Footage Break Fiber Splice Point Storage Loop W Riser Pole Lock Box ■ Footage 150' Text Box Text Callout Arrow New Tap 0 Phase Identifier ❑i Power Suppy ■ Hard Surface Cut • Abandoned Cable SIGN SPACING = X (1) RURAL RC.V' S & UREA\ ARTERIALS 33 140 MPH MA RURAL ROADS. URSAV ARTERIALS. ;5 130 VPH ;:Xla RLSIMMIAL A SWIM:SS CISIRICIS URBAN STREETS 2S MPS OR LFSS 1X14 �. 11 ALL SPACMG MAY or A')JUSTED TO ACCCMVOrA& - "RSECTIOPIS AND ORIVFMYS. :71 THS SPACW MA" RF RFOUCED P1 I.RRN1 ARFAS TO 'I' ROADWAY CO"TIOHS. MINIMUM SHOULDER TAPER LENGTH = U3 (feet) so.t�tR iy0rr 9%00 Posted Speed (mph) 21 3D 35 1 40 1 45 'r, 5" 1 60 1 61 rI a• .� 40 60 00 - - - - lor 40 1 60 1 e0 1 90 USE A 3 DEVICES TAPER FOR 91000*RS LESS THF% A' TRAFFIC CONTROL PLAN TO BE UTILIZED IN VARIED DIRECTIONS BASTED ON WORK LOCATION ALL MAINTENACE SPLICES LOCATIONS TO ADAPT BELOW PLANS TO SITE CON DICTIONS BUFFER DATA LONGITUDINAL BUFFER SPACE = B SPEED (MPH) 25 32 1 35 40 1 45 1 W 55 65 7C LENGTH (Teel) 1 155 1 207 25C 30S 1 360. 1 425 495 5'C 615 730 TRANSPORTABLE ATTENUATOR ROLL AHEAD DISTANCE = R HOST VEHICLE WEIGH' 9.900 TO 22.000 IM. HOST VEHICLE WEIGHT > 22.000 lbe. < 45 MPH 4M5 MPII > 55 NPII < 45 MPH 45.65 MPII > 55 MPti tar 123' '72, 74' 10C' ISO PROTECTIVE VEHICLE (WORK VEHICLE) = R NO SPFCIFIFD NSTANCF RFQUIRF..^. a q O � ® WOIIK ARfA � 0 A ■ n 4C' �!• ROAD WORK SHOULDER PHAWORK \ 4C' 46, W20a W21•5 ENGINEERING DIVISION APPROVED AS NOTED 1%ll W41,$y ,04z 03/09/2023 VV CHANNELIZATION DEVICE SPACING foot UPH 'AP=R TAM..^.F%- )Ssi i5•r 9? t.: RECEIVED FEB 23 2023 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT NOTES LEGEND 1. DEVICE SPACING FOR THE DO'r#hSTREAAI TAPER SHALL BE 2:'iF7. a TEMPORARY SIGH LOCATION SHOULDER CLOSURE - LOW SPEED 2 ALL SIGNS ARE BLACK ON ORANGE. o CHMINELIZING DEVICES (40 MPH OR LESS) ® PROTECTIVE VEHICLE NOT TO SCALE TRAFFIC CONTROL Completed By: COURTNEY MITCHELL Address: 72315TH ST SW EDMONDS WA98020 Completion Date: 2/21/2023 Private Exterior Footages: N1 IProject COMCAST Job Type: Select New Aerial Coax: 0 Overlash Coax: 0 New UG Fiber: 0 New Aerial Fiber: 0 Overlash Fiber: 0 Existing UG Fiber: 0 Empty Conduit Only: 0 New UG Coax: 0 Existing UG Coax: 0 Are Additional Pages Needed: No Job Subtype: Select Survey Scope: Post -Sale Manager: Select Source System: JB0001271303 Legend Provide Clear Construction Details MAINTENANCE SPLICES AT EXISTING AERIAL AND GROUND CASES AT THE FOLLOWING LOCATIONS: 1229 7TH AVE S, 1227 8TH AVE S, 1239 CORONADO PL, 22003 10OTH AVE W, 22047 98TH PL W, 728 13TH WAY SW, 706 13TH WAY SW, 22509 98TH AVE W, 9723 227TH PL SW, 22717 98TH AVE W NO NEW CONSTRUCTION, ALL EXISTING CASES. New Ped ❑ New Vault ❑V Existing U/G Existing Aerial NewLl/G New Aerial ----- Interior Path ----- Exterior Building Path Footage Break Fiber Splice Point Storage Loop Riser Pole Lock Box ■ Footage 150' Text Box Text Callout Arrow New Tap Phase Identifier ❑i Power Suppy PS Hard Surface Cut • Abandoned Cable BUFFER DATA LONGITUDINAL BUFFER SPACE = B SPEED (MPH) 25 30 35 40 45 1 '.0 1 55 6] 65 G LENGTH (Ills" 155 200 250 305 %0 1 425 1 495 1 570 1 645 1 73: TRANSPORTABLE ATTENUATOR ROLL AHEAD DISTANCE = R HOST VEHICLE WEIGHT 9.%0 TO 22.000 bs. HOST VEHICL= VAICH- > 2ZRRF Im < 45 MPH 45.55 MPH > 55 IAPH < 45 MPH 45.55 MPH `5 MPH 100' 12Y 172' 74' 100 i 5- PROTECTIVE VEHICLE (WORK VEHICLE) = R NO SPECIFICD DISTANCE REQUIRED x ONCE LANE ROAD AHEAD 4e' Ia• W20.4 ROAD WORK AHEAD 4a• LEGEND 44 FLAGGING STATION 13 TEMPORARY SIGV LOCATION 0 CHANNELVING DEVICES PROTECTIVE VEHICLE SIGN SPACING = X 11) RURAL HICHVVAYS 60165 MPH 637i RURAL ROADS 45155 M4'R 507_ RURAL ROADS ► URBAN ARTERIALS 35140 MPH 35'7s RURAL ROADS. URBAN ARYFROLLS 25 130 MPII 2017J. ;[! RESIDEA'TIAL 4 BUSIIESS DISTRICTS URBAN STREETS 25 MPH OR LESS (7. ..—I SPACINC MAY BE ADJUSTFO TO ACOOVA#OOATF INTERSECTIONS AN') DRIVEWAYS. .Q THIS S: AGAO MAY OF RFDUCFO IN URBAN ARFAS TO fIT ROADWAY CCHDITICAS. N'J0.70 (CPTIONAL If 44 VP11 OR LESSI lf' 48, BE KU AO PREPAREO WORK TO STOP AHEAD 481 'E' 444 4114 TRAFFIC CONTROL PLAN TO BE UTILIZED IN VARIED DIRECTIONS BASTED ON WORK LOCATION ALL • W20.78 ONE LANE W2a1 MAI NTENACE SPLICES LOCATIONSTO ADAPT BELOW PLANS TO SITE CONDICTIONS ROAD AHEAD 43. •,a TO loov > 1'.0 W20.7A W20.4 it I e ` x x x z 48' BE PREPARED TO STOP 4e• W2O.75 N.L►TR ;OPTIONAL IT 40 MPH OR LESSI ° ENGINEERING DIVISION APPROVED AS NOTED %ill 1 /U/Q.41,,,,,44,t 03/09/2023 VV ONE -LANE, TWO-WAY TRAFFIC CONTROL WITH FLAGGERS \CT TO SC4LE RECEIVED I FEB 23 2023 II CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT CHANNELWTION DEVICE SPACING (FEET) MPH TAPER IA\C.LA' 50W 10 TO 20 ec 3l'45 10 TO 20 CC ZW30 10 TO 20 1 4C NOTES 1. ALL SIGNS ARE "CK ON ORANGE. 2. EXTENDING T14E CHANNFLIZING DEVICE TAPFR ACROSS SHOULDER IS RECOMMENDED. 9. NIGHT WORK REQUIRES ADDIT104AL ROAC4VAY LIGHTING AT FLAGGING STATIONS. SEE THE STANDARD SPECIFICATIONS FOR ADDITIONAL DETAILS. 4. SEE SPECIAL PROVISIONS FOR WORK HOUR RESTRICTIONS. RECEIVED FEB 23 2023 CITY OF EDMONDS M BuildingPermit.corn CITY OF EDMONDS Right -of -Way Application #1272149 - COMCAST - JB0001271303 SERVI ESLOPMENT DEPARTMENT Applicant First Name Last Name Company Name LEAH IHLENFELDT Cablecom LLC Number Street Apartment or Suite Number E-mail Address 19910 NORTHCREEK PARKWAY N SUITE 100 SNOHOMISH.PERM ITTING@CABLECOM City State Zip Phone Number Extension BOTHELL WA 98011 (360) 670-4291 Contractor Company Name Cablecom LLC Number Street Apartment or Suite Number 8602 Maltby Rd City State Zip Phone Number Extension Woodinville WA 98072 (360) 863-2628 (360) 454-3163 State License Number License Expiration Date UBI # E-mail Address CABLEL*971 DP 8/21/2023 Rn99RSS79 SNOHOMISH.PERM ITTING@CABLECO Project Location Number Street Floor Number Suite or Room Number 723 15TH ST SW City Zip Code County Parcel Number EDMONDS 98020 00390000000800 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 Evelyn Anderson Number Street Apartment or Suite Number 723 15TH ST SW City State Zip EDMONDS WA 98020-5119 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: 2/21/2023 Submitted By: LEAH IHLENFELDT Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Right -of -Way Application #1272149 - COMCAST - JB0001271303 Project Contact Company Cablecom LLC Name: Name: LEAH IHLENFELDT Email: SNOHOMISH.PERM ITTING@CABLECOMLLC. NET 19910 NORTHCREEK Phone Address: PARKWAY N SUITE #: (360) 670-4291 100 BOTHELL WA 98011 Project Type Activity Type Scope of Work Utility Purveyor Utility Work No Disturbance of Surface Project Name: COMCAST - JB0001271303 Description of Work: MAINTENANCE SPLICES AT EXISTING AERIAL LOCATION :723 15TH ST SW NO NEW CONSTRUCTION Project Details Project Information Job Number JB0001271303 Page 2 of 2