ROW App signed Graphite 1 2020-04-22-GC. 189U
PROJECT NAME:
ROW PERMIT NO.: ENG
ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
Graphite 1 Art Studio
CONTRACTOR: Ryan General Contractors
Mailing Address: PO Box 751
Woodinville WA 98072
State License #: UBI - 601-316-812 / RYANGC1930PC
City Business License #• Old - NR-025593 / Have recently
submitted through WA DOR / BLS
for city license endorsement
ADDRESS OR INTERSECTION OF CONSTRUCTION:
CONTACT: Bill Lentz
Phone #: 425-330-3637
Fax #: 425-486-2344
Email #: blentz@ryangc.com
❑ Liability Insurance ❑ Bonded
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
N Commercial ❑ Subdivision ❑ City Project ❑ Traffic Control (Only)
❑ Multi -Family ❑ Single Family
❑ EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit?
ANY ASSOCIATED PERMITS?
❑ Other
❑ Yes ❑ No
BLD# ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) : For sidewalks, section overlay of
alley and street as part of commercial building permit. Work to be done per the site and street
improvement plans.
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES ❑ NO ❑ Year:
6 120
PAVEMENT CUT: ❑X Yes ❑ No If yes, indicate size of cut: 30 x 15
CONCRETE CUT: ® Yes ❑ No If yes, indicate size of cut: 250 x 10
RIGHT-OF-WAY
CLOSUREL' A
TOTAL
DURATION
(NUMBER OF MONTHS)
Sidewalk 48 Hrs + 250 LF
X
10 LF
2500 SF
10
Alley 72 Hrs + 275 LF
X
16 LF
4400 SF
10
Parking 72 Hrs + 250 LF
X
g LF
2000 SF
10
APPLICANT TO READ AND SIGN
*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 is to 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.
Indemnify: The Applicant has signed an application which states helshe hold 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 defense costs and attorney fees by reason
of granting this permit
I have read the above statements and understand the permit requirements and acknowledge that I must
follow all requirements ' for the emit to be valid.
SIGNATURE d; � IL 61(, DATE
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE