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ENG2023-0137 ROW PERMIToff' EIDM �~ o�RIGHT OF WAY EUC PERMIT o ,N UM EdmondsCity of Edmonds PERMIT NUM 121 5th Ave N, 98020 1 1 www.edmondswa.gov i Description: COMCAST-PROOF AND PULL CATV THROUGH EX CONDUIT ISSUED: 04/10/2023 Address: 931 12TH AVE N EDMONDS WA 98020 EXPIRES: 10/10/2023 Permit Type: RIGHT OF WAY EUC Permit Subtype: MINOR Parcel Number: 00507000001800 CONTACTS NAME TYPE NAME ADDRESS PHONE APPLICANT JESSAMIN SANTOS 410 VALLEY AVE WA, PUYALLUP WA 98371 (425)770-0020 CONTACT COMCAST 410 VALLEY AVE WA, PUYALLUP WA 98371 (425)770-0020 CONTRACTOR CABLECOM LLC 1316 BONNEVILLE AVE, BLDG A, SNOHOMISH WA 98290 (360)668-1300 OWNER CESAR R SARAUSAD 931 12TH AVE N, EDMONDS WA 98020 FEE INFORMATION DESCRIPTION AMOUNT PAID CITY TECHNOLOGY FEE - PER PERMIT $45.00 $45.00 ENG - INSPECTIONS $126.00 $126.00 RIGHT-OF-WAY PERMIT - MINOR $126.00 $126.00 REQUIREMENTSJIL 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: 04/10/2023 Printed: Monday, April 10, 2023 8:40:22 AM 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 X-2 ENGINEERING FINAL" Printed: Monday, April 10, 2023 8:40:22 AM 2 of 2 RECEIVED of EUAgoy� MAR 17 2023 ` RIGHT OF WAY CONSTRUCTION PERMIT APPLICATION CITY OF EDMONDS DEVELOPMENT Complete and submit this Application in accordance with the Submittal SERVICES DEPARTMENT INc. 100 Requirements outlined in Right -of -Way permit Handout E6�. 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 Info Project Name COMCAST - JB0001347565 Site Address or if no site address use Property Address at NW corner of project area: 931 12TH AVE N EDMONDS WA 98020 Associated Permits: BLD PLN ENG • applicable) Name of CompanyCOMCAST CABLE HOLDING Franchise Ordinance No: Point of Contact J ESSAM IN SANTOS Title PERMIT COORDINATOR Address410 VALLEY AVE NW City PUYALLUP State WA Zip 98371 Phone (206)401 - 2188 Email WACONSTRUCTION JOINTUSE@COMCAST.COM Contractor and Authorized Agent of Owner (see note below) Name of Company CABLECOM LLC Contractor Contacts During Construction Primary Name CABLECOM LLC - MICHAEL FINCH Agent NameLEAH IHLENFELDT Title CONSTRUCTION SUPERVISOR Title PERMIT SUPERVISOR Mobile (360)965-5085 Address 19910 NORTHCREEK PARKWAY N, STE 100 Email MICHAEL.FINCH@CABLECOMLLC.NET City BOTHELL State WA Zip 98011 Secondary Name Phone (360)670-4291 Title Email SNOHOMISH.PERMITTING@CABLECOMLLC.N ET Mobile City of Edmonds Business License No: N R-021818 Email State License No: CABLEL'971 DP yJ Contractor verifies it is currently bonded Contractor verifies it currently has general liability insurance NOTE: ECDC18.6o.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 1 of 3 Updated 3/25/2021 \-� Utility 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.) PROOF AND PULL 187 OF CAT V FROM 931 12TH AVE N TO 911 12TH AVE N RIGHT-OF-WAY CLOSURE AREA TOTAL DURATION (Number of Months) Sidewalk 72 hours + LF x LF SF Alley 72 hours + LF x LF SF Parking 72 hours + I LF JxJ LF I SF SECTION B - If you are not a utility company performing work in the City ROW, skip to SECTIONC. 1. The work in the right of way is on or for the following type of facilities: ❑ telecommunications d cable ❑ power ❑ gas ❑ water ❑ sewer ❑ storm Details of Work to be Completed 1. Does the utility owner have existin overhead infrastructure in the area of work? Yes No 2. Will any equipment be added underground or above ground (e.g. pedestals, vaults, etc.)? 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 existingunderground common utilitysystem? X 5. Does the work involve proposed additions to an aboveground utility system? If es: 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. 1 Does your project involve rebuilding or replacing utility equipment which currently serves more X than one lot or commercial development? /� 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: 6a. Does your project involve wires/cables/lines? If yes: X How many are existing? I I How many are to be added? 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 additionalpoles 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: 3/14/2023 APPLICANT PRINTED NAME: LENAIZA ENRIQUEZ 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 ROUTE OVERVIEW Completed By: LEN ENRIQUEZ Address: 931 12TH AVE N EDMONDS WA98020 Completion Date: 3/14/2023 Right of Way Footages: Job Type: Span Replacement 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: JB0001347565 Legend Provide Clear Right of Way Construction Details PROOF AND PULL 187 OF CAT V FROM 931 12TH AVE N TO 911 12TH AVE N EXISTING Ped ❑ SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM New Vault ❑� Existing U/G r-+ Existing Aerial N r New U/G New Aerial ----- Interior Path Exterior Building Path Footage Break Fiber Splice Point ►I Storage Loop CD Applicant shall repair/replace all Riser iS`a Way damageto utilitiesore improvements in City rfight-of-wa y ® per city standards that is caused or Pole occurs during the permitted project. Lock Box ❑ ENGINEERING DIVISION Footage 150' APPROVED AS NOTED Text Box Jl11 "J,$,44z 04/05/2023 Text VV Callout Arrow New Tap 0 RECEIVED Phase Identifier 0 _ MAR 17 2023 Power Suppy Ps L Hard Surface Cut N CITY OF EDMONDS O r DEVELOPMENT Abandoned Cable SERVICES DEPARTMENT ASBU ILT COVER Completed By: LEN ENRIQUEZ Completion Date: 3/14/2023 Address: 931 12TH AVE N EDMONDS WA 98020 Job Type: Span Replacement Job Subtype: Select Footages Entered On Right of Way, Private Exterior, and Private Interior tabs. Footages Survey Scope: Post -Sale are summarized on Survey Rollup tab. .s Project Manager: Select Source System: JB0001347565 Are Additional Pages Needed: No Legend Provide Clear Route Overview Construction Details New Ped ❑ PROOF AND PULL 187 OF CAT V FROM 931 12TH AVE N TO 911 12TH AVE N New Vault ❑V Existing U/G Existing Aerial �.,* o-est �� o« i New U/G A<°bv o �{ �" .�o.w S, New Aerial — — — — — d Puget Dr 'g Interior Path w • »r.,« sr sw S Exterior Building Path — — — — — Footage Break 4• 36-1 Ll V-•a^o Way t sW s Fiber Splice Point / ? Storage Loop CD Riser dmonds 3 200th St SW Pole Lock Box ` ,�: •- . Footage 150' ..: are J• Text Box Text f.., ,�,, �•, r ? ; Callout Arrow d '- < New Tap o Q i S"' ` RECEIVED '03-J4 _ 8 ,,�y Phase Identifier 0 _� MAR 17 2023 _ - Power SuppY +�...,.,� % CITY OF EDMONDS 7x•, r' S„ ; DEVELOPMENT Hard Surface Cut • SERVICES DEPARTMENT Abandoned Cable " TRAFFIC CONTROL Completed By: LEN ENRIQUEZ Address: 931 12TH AVE N EDMONDS WA98020 Completion Date: 3/14/2023 Private Exterior Footages: Job Type: Span Replacement 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: JB0001347565 Legend I Provide Clear Private Exterior Construction Details 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 71 V❑ 150' Text 0 PS O PROOF AND PULL 187 OF CAT V FROM 93112TH AVE N TO 91112TH AVE N SIGN SPACING = X (1) 41..RA. ROADS 8 URBAN ARTFRIALS 35 !40 MPH )WA +.. ROADS. URBAN ARTERIALS, 2S 130 MPH 'InIN11AA ♦ BUSINf SS CISTRI-TS 207A M .HIiAN STRLETS 25 MPH OR LESS iWA W 0I ALL SPACING MAY BE ADJUSTLO TO ACCOVMOOATE INTERSECIIOAr3 AND DRMYM�B. M 748 SPACING MA' BE RED-CED IN LRBAN AREAS 70 ROAMAAY CONDITIONS FIT WHIMUM SHOULDER TAPER LENGTH = LJl (feet) VNXXAD1ER Posted Speed (mph) VWDT paa) 25 30 35 4) Z 3 e' 40 40 40 90 10, 40 60 lCl 90 USE A 3 DENICES TAPER FOR SHOULDERS LESS THEY a b s 12TH AVE N k e� - a a O O 1R011K AREA D O > X 1• „ 57 BUFFER DATA LONGITUDINAL BUFFER SPACE = B SPEED (MPH) 25 30 35 40 45 50 55 60 65 10 LENGTH (!ee0 155 200 250 305 3W 42S 495 570 645 73C TRANSPORTABLE ATTENUATOR ROLL AHEAD DISTANCE = R HOST VEHICLE WEIGHT 9.900 TO 22,000 be HOST VEHICLE WEIGHT > 22.000 bs. < 45 MPH 4S.SS MPH > 55 MPH < 45 MPH «SS MPH > 55 MPH T 00' 121 172 74 100 tY:; PROTECTIVE VEHICLE (WORK VEHICLE) = R NO SPECIFIED DISTANCE REQUIRED CHANNELIZATIOY DEVICE SPACING (feet ItPH -_�-t TANGENT >.440 60 /YID 2O 40 t@r / A• ROAD r// WORK SMOULDER ENGINEERING DIVISION woRl( APPROVED AS NOTED AO \\/ Ott' 4ti• wm.1 1m.5 %ll LIIQ.i joe,44z 04/05/2023 VV LEGEND NOTES 1. DEVICE SPACING FOR THE DDYASIREAM TAPER SHALL BE 27IF';. a TEMPORARY SIGH LOCATION SHOULDER CLOSURE -LOW SPEED 2. ALL SIGNS ARE BLACK ON ORANGE. O CHANNEL04G DEVICES ® PROIFCTIVF VFHCIF (40 MPH OR LESS) NOT TO SCA-=_ RLE NAME >I'DP•1 � R P4 S'bSun N.wJil•� SAM IIMP glhHNhM >St'rTC, YMC.L Za T.MIC CewoN TC.T, Dhwld•C Cl—, • . S w L4 PTCAA4r. . 1 TIME ];"A, PM '•�' • " FFD.AID PROJAO, ...w � DATE /-=1t � PWTTLD 0� IIIMII WAS A TCS oEslolco By WashingtonState C%Tf RED By ' �• CHEM= BT ...... ... 1-.. De Wrlment of Transportation MCA EWOR' •.. TRAFFIC CONTROL PLAN .�'. REGIONAL ADIT. RF'.t S10•. nCTr Rr .,�..... �. �.•.+ . . RECEIVED MAR 17 2023 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT RECEIVED MAR 17 2023 CITY OF EDMONDS M BuildingPermit.com CITY OF EDMONDS DEVELOPMENTRight-of-Way Application #1283142 - COMCAST - JB0001347565 SERVICES DEPARTMENT Applicant First Name Last Name Company Name JESSAMIN SANTOS COMCAST Number Street Apartment or Suite Number E-mail Address 410 VALLEY AVE WA WACONSTRUCTI0N JOINTUSE@COMC City State Zip Phone Number Extension PUYALLUP WA 98371 (425) 770-0020 Contractor Company Name Cablecom LLC Number Street Apartment or Suite Number 19910 NORTH CREEK PARKWAY NORTH City State Zip Phone Number Extension BOTHELL WA 98011 (360) 863-2628 (360) 454-3163 State License Number License Expiration Date UBI # E-mail Address CABLEL*971 DP 8/21/2023 FD99RSS79 SNOHOMISH.PERM ITTING@CABLECO Project Location Number Street Floor Number Suite or Room Number 931 12TH AVE N City Zip Code County Parcel Number EDMONDS 98020 00507000001800 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 Cesar R Sarausad Number Street Apartment or Suite Number 931 12TH AVE N City State Zip EDMONDS WA 98020 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: 3/14/2023 Submitted By: JESSAMIN SANTOS Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Right -of -Way Application #1283142 - COMCAST - JB0001347565 Project Contact Company COMCAST Name: Name: JESSAMIN SANTOS Address: 410 VALLEY AVE WA PUYALLUP WA 98371 Project Type Utility Purveyor Email: WACONSTRUCTION_JOINTUSE@COMCAST.COM Phone (425) 770-0020 Activity Type Scope of Work Utility Work No Disturbance of Surface Project Name: COMCAST - JB0001347565 Description of Work: PROOF AND PULL 187 OF CAT V FROM 931 12TH AVE N TO 911 12TH AVE Project Details Project Information Job Number JB0001347565 Page 2 of 2