ENG2023-0232 ROW PERMIToff' EIDM
�~ o�RIGHT OF WAY EUC PERMIT
o
, UM
EdmondsCity of Edmonds PERMIT NU
98020 1 1
www.edmondswa.gov i
Description: PSE - ADJUST VALVE CAN TO ACCESS VALVE WITH SIDEWALK CUTS
ISSUED: 06/08/2023
Address: 7215 212TH ST SW EDMONDS WA 98026-7735
EXPIRES: 12/08/2023
Permit Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 00566900500400
CONTACTS
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 NATION LAND COMPANY LLC
4300 STERILITE ST SE, MASSILLON OH 44646
FEE INFORMATION
DESCRIPTION
AMOUNT PAID
CITY TECHNOLOGY FEE - PER PERMIT $45.00 $45.00
ENG - INSPECTIONS $378.00 $378.00
RIGHT-OF-WAY PERMIT - STANDARD $378.00 $378.00
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: 06/08/2023
Printed: Thursday, June 08, 2023 8:45:18 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"
E-7 TRAFFIC CTRL
E-7 CONCRETE SIDEWALK
E-7 RESTOR LIMITS
Printed: Thursday, June 08, 2023 8:45:18 AM 2 of 2
ofEOMotio� RECEIVED
RIGHT OF WAY CONSTRUCTION MAY 03 2023
PERMIT APPLICATION
Complete and submit this Application in accordance with the Submittal CITY OF EDMONDS
P pp DEVELOPMENT
is') Requirements outlined in Right -of -Way permit Handout E6�. 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.
SECTION A
General •
Project Name 887038338
Site Address or if no site address use Property Address at NW corner of project area: 7215 212 ST SW
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 ix Single family -other ❑ Industrial
❑ Demo and rebuild or from vacant land?
ixOther, please specify: Valve
❑ 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.)
Dig up HP valve and center valve box's over valve. "Valve is inacessible with key." Verify 2 valves on north end of
dr 30'W C/L 72nd ave W & 40' S C/L 212th St SW. (1) 4x4 concrete sidewalk 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 3xgas
❑ 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: 04/27/23
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
RECEIVED
MAY 03 2023
Job #:
Date:
Jurisdiction:
ROW Permit:
Est. Start Date:
Est. Duration:
Puget Sound Energy Gas Pre -Inspect Form
887038338 Service Address: 212th St SW & 72nd Ave W
City Edmonds zip: 98026
Edmonds Customer: Phone:
Yes Customer Email:
PM / Inspector: Tanya Martinson Phone:
1 Day Site Contact Email: Mitchell Goetz Phone:
Job Description
Dig up HP valve and center valve box's over valve. "Valve is inacessible with key."
New Construction:
Verify 2 valves on north end of dr 30'W C/L 72nd ave W & 40' S C/L 212th St SW.
No
Construction Method
vac
RESTORATION LIMITS TO BE DETERMINED
Building Foundation Type
BY CITY ENGINEERING INSPECTOR
N/A
Septic System
No
PLAT Map: 164.070
It
I i I
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UTILITIES IN ROW: N
EDMONDS STORM
Iry I
z
' I ' 0 '
EDMONDS WATER
EDMONDS SEWER
LYNNWOOD SEWER
C ,
EDMONDS SIGNAL LOOPS
I C
CALL FOR LOCATES
POW & COM
• I 1
I I I
I I
5' CONC SIDEWALK
,
-- — — — — — — — — ——--—J---------t-1-------1_�I ———————————————————————
' 212TH ST SW
� I I
----------- - - -�-_ -----��' ------'._._J.------------------
I I I
6" STW 14'S
— ---ICY-- — — — — — — — — —}---——————— r————————————————— — — — — — —
I
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--————————————i————— — — — — —— --�
5' CONC SIDEWALK
O O I I
COORDINATE WITH
'
DR
I '
ANTHOLOGY DEVELOPMENT
'
NOTE: VALVES NOT
DRAWN TO SCALE.
RESTORATION IN �0� '
ENGINEERING DIVISION
..., DTED
_ /v� 16/07/2023
SIDEWALK. ROW
Work
Location
Size of Cut
Surface Type
40'
1 S
I of CL
1212TH ST SW
&
2n'
W
I of CL
172ND AVE W
4 X 4 X
C/SW
Of CL
I
&
I of CL
Service Information
Street Information
Job Type
Diameter:
0
Flaggers #:
2
Arterial:
No
EFV:
0
Police #:
0
TCP:
No
Tie -In Fitting
Meter:
Speed Limit:
35
No Parks #:
0
Meter Loc:
0
Trolley Lines:
No
Mtr Hoods #:
0
Del Press:
Traffic Signal:
Bus Stop:
No
Bollards:
2.5" #
4" #
I
I ADA Ramps #:
Route #'s:
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
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.
OWNER/CONTRACTOR IS RESPONSIBLE FOR
EROSION CONTROL AND DRAINAGE
TEMPORARY TRAFFIC CONTROL PLAN
TRAFFIC CONTROL INSPECTION SHALL BE
REQUIRED WHENEVER WORK ZONE IS SET UP
.... .... .... ....
................... e
200'-
200'- 200'______________________________
cb
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m 0 0
Dp
•
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p rn m
W20-1
W20-7A
CO
ENGINEERING DIVISION
....'OTED
�J G-- iV 16/07/2022
IF CLOSING INTERSECTION, CITY
OF EDMONDS UPO REQUIRED.
TO REQUEST AN OFFICER,
CONTACT JASON SHIER AT
206-353-2987 AT LEAST 10 DAYS
PRIOR TO START OF WORK.
(SEE ATTACHED OFF DUTY
DETAIL)
a' S/W
CLOSED
SIW CLOSED
CROSS HERE dj
PLACE SIGN AT
INTERSECTION OF 72ND AVE
W & 213TH PL SW
Notes:
1. All signs and spacing to conform to the
MUTCD and City of Edmonds standards.
2. All sidewalks, driveways, exits and egresses
shall be completely clear unless otherwise indicated.
3. Channelizing devices are 28" traffic cones.
Use traffic drums (barrels) with steady burning
Type C lights on all State State Routes and Hwys.
4. Sign size can be a minimum of 36" x 36" and
shall not obstruct pedestrian access.
5. Crew is required to leave a minimum of 10' for
traveling lane width.
6. Alert affected residents and businesses.
7. Work to take place between 9 a.m. and 4 p.m
unless otherwise specified. All work for arterials
and major roadways will be from 9 a.m. to 3 p.m.
8. Work area will be 40' SCL of 212th St SW & 30'
WCL of 72nd Ave W
4
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20
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____________________________
c _ _ _-200'
_.......................................................
b .... _
b�
-------------------------------------------------
212TH ST SW
r
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I
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RESTORATION LIMITS TO BE DETERMINED
t BY CITY ENGINEERING INSPECTOR
I
1HJIb
I
le
d33yi
KEEP RESIDENT(S) WILL BE INFORMED
� OF TEMPORARY DRIVEWAY
RIG CLOSURE
I
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I
zipI
o,
a
I
PLACE SIGNS ALONG
WORK AREA
OWNER/CONTRACTOR IS RESPONSIBLE FOR
EROSION CONTROL AND DRAINAGE
OWNER/CONTRACTOR RESPONSIBLE FOR LOCATING
ALL ON SITE UTILITIES. RELOCATION/REVISION TO ANY
o Q UTILITIES MAY REQUIRE A SEPERATE PERMIT.
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1
23 23
o
ROAD
WORK N
HEAD
SIGN SPACING
55 +
"X"
60/65
800
45/55
500'
35/40
350'
30
200'
25
100,
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.
CHANNELIZATION
DEVICE SPACING
MPH
TAPER
TANGENT
55/70
40
80
35/45
30
60
25/30
20
40
MINIMUM TAPER LENGTH=L (FT.)
LANE
WIDTH
20
25
POSTED SPEED (MPH)
30 35 40 45 50
55 60 65 70
10
70
105
150
205
270
475
500
550
-
-
-
11
75
115
165
225
295
495
550
605
660
-
-
12
80
125
180
245
320
540
600
660
720
780
840
RECEIVED
MAY 03 2023
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
I LEGEND
®
28" TRAFFIC CONE
®
WORK PIT
TRAFFIC FLOW
ItUNIFORMED
POLICE OFFICER
FLAGGER
WORKVEHICLE/
FLASHING LIGHTS
SIGN LOCATION
RIGHTOFWAY
OCHEVRON
ARROW BOARD
Puget Sound EnerC.gy REV
PUGET Designer: Tr al Control u,—wr:
SOUND Kali-Jamal Collins Card No.013375 04/18/2023 0
Card Exp. 1ENERGY 424-425-6425 KaliJa al.Coli s@pse.com 0/2026 Job #
(425)424-0425 11891289
Kali-jamal.collins@pse.com
Project Address:
7215 212nd St, Edmonds, WA Page 1 OF 1
OFF DUTY DETAIL INFORMATION SHEET
EDMONDS POLICE OFFICERS ASSOCIATION
250 5T" AVE N, EDMONDS, WA 98020
The purpose of this sheet is to provide information regarding the requesting of; cost of; and
procedures for scheduling Police Officers for'off-duty' details within the City of Edmonds.
Point of Contact:
• Officer Jason Shier, EPOA Vice President:
o Email: vicepresident.epoa@gmai1.com.
o Cellular phone: 206-353-2987
Requesting an officer: (Please request an officer with as much advance notice as possible!)
• To schedule an officer, please email Officer Jason Shier at
vicepresident.epoa@gmail.com. Please include your company name, Point of Contact
(name, phone number, and email), location of the detail, date(s) and time(s) of detail,
and a brief description of what officer will be doing (i.e. directing traffic, closing a traffic
lane, providing security, etc).
• Additionally, if your Point of Contact is NOT the same person to whom the invoice is to
be sent, please include the 'Finance Person's': name, email address, and phone
number.
NOTE: Oficer Shier works a rotating schedule, so to insure that your detail request is
received and reviewed in a timely manner, it is recommended that you call his cell phone
in addition to sendina the email.
Rate of Pay: (NOTE: Minimum of 4 hours will be paid to the officer)
• Requests made 7 or more days in advance: The rate of pay for an officer working an off -
duty detail will be $75 per hour.
• Requests made less than 7 days in advance: The rate of pay for an officer working and
off -duty detail will be $80 per hour.
1
Effective: May 24, 2018
OFF DUTY DETAIL INFORMATION SHEET
• Details that fall on a holiday will be paid at an additional $30 per hour ($105 per hour
with 7 or more days notice/$110 per hour if less than 7 days notice).
List of Holidays:
New Year's Day (January 1)
Washington's Birthday (Third Monday of February)
Independence Day (July 4)
Veteran's Day (November 11)
Friday following Thanksgiving Day
Martin Luther King Day (Third Monday of January)
Memorial Day (Last Monday of May)
Labor Day (First Monday of September)
Thanksgiving Day (Fourth Thursday of November)
Christmas Eve (December 24)
Christmas Day (December 25) New Year's Eve (December 31)
Cancellations: (Note: date and time of cancellation will be based on the date and time of the
phone call, not email.)
• To cancel an officer, you MUST call Officer Shier at 206-353-2987. Additionally, please
follow up the phone call with an email to vicepresident.epoa@gmaii.com requesting
the cancellation If you cancel an officer more than 24 hours before the start of the
detail, you will not be charged for the cancelled detail.
• If you cancel an officer less than 12 hours prior to the start of the detail, you will be
charged for the '4 hour minimum'.
• Administrative fees will still be charged for all details, regardless of when they are
cancelled.
Payment Deadlines:
• If you do not require an invoice, officers are to be paid via check or cash at the start of
the event. (check made payable directly to the individual officer(s).
• If you require an invoice, officers should be paid within two weeks of invoice being
emailed to your Point of Contact (or Finance if provided).
• Delays in paying officers may result in difficulty obtaining officers for future details.
2
Effective: May 24, 2018