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ENG2023-0175 ROW PERMITRIGHT OF WAY EUC PERMIT PERMIT NUMBER City of Edmonds - N, Edmonds WA 98020 ENG2023-0175 www.edmondswa.govi Description: ZIPLY- RUN RED JUMPER OVERLASH & UPSIZE PIED ISSUED: 07/24/2023 Address: 21830 76TH AVE W EDMONDS WA 98026-7900 EXPIRES: 01/24/2024 rmit Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 00461000200102 i NAME TYPE NAME ADDRESS PHONE APPLICANT VICTORIA COMER 1800 41ST STREET STE N-100, EVERETT WA 98203 (830)513-6614 CONTACT ZIPLY FIBER 1800 41ST STREET STE N-100, EVERETT WA 98203 (830)513-6614 CONTRACTOR ZIPLY FIBER 1800 41ST ST, EVERETT WA 98201 (425)949-0230 OWNER PROVIDENCE HEALTH & SERVICES 800 5TH AVE 1200, SEATTLE WA 98104 WASHINGTON 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 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: 07/24/2023 Printed: Monday, July 24, 2023 10:22:22 AM 1 of 2 RIGHT OF WAY EUC PERMIT PERMIT NU�IBEJ City of Edmonds 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 E-7 TRAFFIC CTRL X-2 ENGINEERING FINAL** Printed: Monday, July 24, 2023 10:22:22 AM 2 of 2 RESUB Lti�y of ED%�O� ANC. 1 g90 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. Jul 11 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 Info Project Name 5520227 Site Address or if no site address use Property Address at NW corner of project area: 21830 76TH AVE W Associated Permits: BLD PLN ENG Owner and Entity Holding Franchise (if applicable) Name of Company Ziply Fiber Northwest, LLC Franchise Ordinance No: WN U-17 PointofContact Mike Hakahan Title Engineer Address1800 41 st St., Ste. N 100 city Everett State WA zip 98203 Phone 425-949-0230 Email mike.hakahan@ziply.com AuthorizedContractor and Agent •below) NameofCompany Ziply Fiber Northwest, LLC Primary Name Mike Hakahan Agent Name Mike Hakahan Title Engineer Title Engineer Mobile 425-949-0230 Address1800 41st St. Ste. N100 Email mike.hakahan@ziply.com city Everett I State WA zip 98203 Secondary Name Phone 425-949-0230 Title Email mike.hakahan@ziply.com Mobile City of Edmonds Business License No: 313-013-420 Email State License No: ZIPLYFN782L3 0 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 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.) Telecommunications and broadband provider Ziply Fiber to Access terminal and run red jumper. Access pole 5 then overlash approx. 878' to pole 3s2 and riser down. Pull fiber through underground existing conduit approx. 122' with a total of 1000' 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 ❑ cable ❑ power ❑ gas ❑ water ❑ sewer ❑ storm 1. CompletedDetails of Work to be Does the utility owner have existin overhead infrastructure in the area of work? • X 2. 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: 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? Details of • to be Completed ®i 6. Does your project involve rebuilding or replacing utility equipment which currently serves more than one lot or commercial development? r 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: 6a. Does your project involve wires/cables/lines? If yes: X How many are existing? 12,258 1 How many are to be added? 16 6b. Does your project involve poles? If yes: X How many poles are existing in the project area? 3 What is the height of the existing poles? LINK How many poles are to be removed? none Are additional poles to be laced? 0 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: 7A4ZW_4Zd1 . _4".C1 APPLICANT PRINTED NAME: Marcus Luna APPLICANT TITLE: TCP SPECIALIST NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE 7/10/2023 City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021 IonMJH1 NOIl �f14�H S —J�' I'' '''I 898 02.2009 1 CERTIFY THAT THE WORK I COMPLETD ON THIS WORK ORDER 1/�\` R B N `� \ e ANDAS-BUILT IS INCOMPLIANCE WITH FRONTIER QUALITY ��((( STANDARDS AS IDENTIFIED ON THE IPQIP CHECKLIST. XD,1-28+ O --- ----------�_ \ HLLKWAXX H5001,29-48 I — _ — _ — _ — _ — — — — — 21 8 TH ST SW OI (SIGNATURE AND DATE) ' RISER DOWN POLE THEN CONTINUE PULL TOTHOURS I O UNDERGROUND THROUGH EXISTING � SUPERVTTED CONTACT SUPERVISOR IF ADDITIONAL J a_ CONDUIT TO CUSTOMER ® HOURS ARE REQUIRED TO COMPLETE PROJECT CAP. X-TIME MAINT CREW 0 0 o 100M PROVIDENCE HEALTH ' _ \\ \ 21822 76TH AV \\ SPLICING 0 0 0 W.O. DRIVER CONSTRUCTION START PL 6 PORT E/W 1000'TAIL ' POLE 3S2 TEST H5001,48 FROM MPOE O \ SNO CO PUD 1000 08.2008 \ ® ETHERNET 03/31/23 BACK TO FIBER HUB 5001 FTTP PIGTAIL 1000FT 4 /E3 ❑ CIAC ❑ DAMAGE IN SERVICE DATE TEST FC1031,754 FROM HUB BACK HLLKWAXX H5001,96+ ❑ OTHER 06/09/23 TO HALLS LAKE CO (HLLKWAXX) XD,2-4 CONSTRUCTION ON PLANT. HLLKWAXX/2100 - ❑FLAGGING ❑BRUSHING ❑CONTRACTOR PERMITS BAY: FDF 011 - O _ M/S: 33 - PORT. 38 ACCOUNT CODE 500 02.2009 MUNICIPALITY: CITY OFEDMONDS HLLKWAXX 1224503 FDT 6P 1000FT CHANGE ONLY MDU FIBER TERMINAL 6 ❑ BLANKET IN:XD,1-5+ "V ____ HLLKWAXX H5001,31-35+ M TCP/TRAFFIC HLLKWAXX H5001,48 219TH ST SW XD,1 ® DETAILED (NOT BLANKET) OUT: TERM 50 0 ' O ❑ NO PERMIT REQUIRED JOINT POLE 2422.101 I 646 06.2010 C95ES F344 ' OVERLASH 91 YJD 12 JFN/NJUNS# 0 PULL 200' IN 2" WITH EXISTING COPPER CA XD,1-4+ ❑ NO JPN REQUIRED FROM MPOE TO PED F348 �� HLLKWAXX H5001 29-30+ POLE 4S2 ' POLE JPN JPN OWNER TO FROM E XD,7-12 PL 100' IN 2" PED F348 UNDER 76TH AVE W SNO COI ❑ ❑ ® POWER TO POLE 3 (AFTER EXPOSING END OF CONDUIT AND PUD I COUNT CHANGE ❑ ❑ ❑ ATV ❑ ❑ ❑ FRONTIER EXTENDING IT INTO PED ) � OVERLASH 195' FROM POLE 3 TO POLE 5 11242, 2°1 300 02.2009 ACCOUNT CODES PL 1000' SPL AT FTTP MDU 30OFT 24 ❑ 2411.001 POLES ®2422.201 UG FIBER ❑ 2421.101 OH COPPER ❑ 2441.001 CONDUIT FTTP PIGTAIL 1000FT 6 I POLE 5 HLLKWAXX 5001 36-47+ 02421.201 OH FIBER ❑ 34XX.XXX REMOVAL XD 1-5+ I OLE 5 XD,13 (HLLKWAXX H 5001, 48)+ ❑ 2422.101 UG COPPER ❑ 64XX.XXX MAINT. POINT OF CONTACT JOE BREWER 713-705-7703 HLLKWAXX H5001,48 XD,14-24 I EMAIL: JOEPH. BREWER@PROVIDENCE.ORG SCHEDULING: JOHN WOOD PHONE: 425-261-1412 -----------------_-_-_-_-_-_ ____ ENGINEER: MIKE HAKAHAN ---------------_ PHONE: 425-949-0230 220TH ST SW i FACILITIES: SHAWN CONKLIN PHONE: 425-263-4010 O 122' Ld Ld FIELDED BY: N/A 0 2" SCH 40 PVC AKF 100 24 Q '}oefoid pal wied ay1 5uunp sin000 ON NOTE: Mf Jo pasnea sl }e41 spaepuels {1ia Jad60' XD1-10+ H 100PR COPPER CABLE Z' I iber (en-;o-lyBla A313 ul sjuauanoadul C95ES DCG 111-150+ abelL ao saIIIIRn of abewep TOWARDS PED F348 IS XD,51-100 Ile aaeldaJ/aledai Ilegs lueallddV NTO PED. HAND DIG 10' TO HLLK - 100M PROVIDENCE HEALTH 2" SCH 40 PVC _ACE SPLIT DUCT OVER COPPER 21822 76TH AVE W, EDMONDS, WA 40' ® CABLE AND SWEEP INTO PED PROJECT 5520227 NUMBER XCH E CODE DE EXCH_ 51419 I DRAWN DATE: ENGR: M. HAKAHAN NTY: SNOHOMISH 3/16/23 PHONE:425-949-0230 FILE: SCALE: 1.100 1 TAX DISTRICT: DWG 3 OF 3 TWNSHP RING: SEC: £ZOZ/tlZ/LO 4310N SV G�IAO JddV NOISIAI4 DN12J331\1I0N3 11\13W12iVd3C S301AH3S 11\131AdO�3A30 SONOWO3 HO,1110 £ZOZ 60 Ae" HLLK - 100M PROVIDENCE HEALTH, 21822 76TH AVE W, EDMONDS, WA tEV2 — 04/10/23 sii5252 — revised to reflect required hand -digging and repair of recorded conduit on F6�' AVE W. tEV1— 03/20/23 sii5252 — revised to reflect correction on field conditions. _STIMATE 29721-5 — ASR3438753 —10CM — PROVIDENCE HEALTH & SERVICES, 21822 76tr AVE W, DMONDS, WA Drder: ASR 3438753 :arrier: TIM E WARNER TELECOM =nd User: PROVIDENCE HEALTH & SERVI address: 21822 76TH AVE W, EDMONDS, WA 98026 service Requested - Access Type: Ethernet - NID Band-.vidth: 100M ircuit ID: 86/KRG N/385706?` ?`N':^ IFC/ )SAT #: 2662729 3DT #: ;alesForce #: ?ON #: A444346201NO1 -xtension Required: No .CON: .ontact: JOE BREWER )hone: 713-705-7703 :mail: JOSEPH.EPELVER:2F' Ci'''DENCE.ORG >roject Manager: Steve Jones ange - CLU: HLLKWAXX Plant Code: 2100 -opper Termhal: C95ES — F344 -opper Count: XD:1-10+DCG:111-150 :iberTerminal: NEW PLCMNT(6-PORTTERM TAIL)' Tiber Count: XD:1-5+H5001:48 1_1 CODE 1 (SWC): HLLKWAXX LI CODE 2 (CUST): EDMNWAEI (2182276t' AVE W, EDMONDS, WA) _STIMATE #: 29721-5 /ARASSET WO#: W0945343 )SP PROJECT#: 5520227 AVE % , Edmonds, WA to FRONTIER POLE 5 found on 764- AVE W, north of 220� ST SW. The Terminal tail r upsize ped at PED F348; hand digging as Fe quiFed POLE SS2 (47), and guys and aneheFS Wili he FeqLi;Fed at POLE 3S2 and POLE SS2. NewfibeF tail wall he takQA From PFD F249 up POLE 252? AAd head conth +a 1201 C 452 on novr"PaA i AAd thou ovo dwh ap existing flberbe4ween 128LE 4S2 and POLES. POLES 3S2, 4S2and ESc` aFe en `he, _:_;a V_ This project will place and splice a new 1000' 6-port terminal tailfrom the customer MPOEat 2182276"' AVE W, Edmonds, WA to FRONTIER POLE 5found on 76' AVE W, north of 220p" STSW. The Terminal tail will be placed from the customer MPOE using customerconduit to PED F348 (identified as PED 1495P3S2 in FROGS), in f ront of customer location, upsize ped at PED F348, hand diggingwith possible repair is required around the RED to determine the existence of recorded cond uitcrossing of 767 AVE W to POLE 3 on the eastside of the road. The newf iber tail will be take n from PED F348 across to POLE 3 then south to POLE 5 ovedash on existing copper cable between the two poles on the eastside of 76' AVE W. There should be an exis.ingfibersplice location at POLE 5forthe exis.ing48F cable (!PID96575 with COLm.of XD:1-28+1-1500_:29-48). The CC Lim. for the nee:,, 6-por.terminal .ail ;rill be XID,i- 5+H5001:48/F C1031:754. FIELDING NOTES: NOEUC:s..—CopperTerminal:C95ES—F344onsite. There is no fiber Terminal On sire. Currentcopper facilities leave MPOE in 2" conduit. 2 condLli.visible in PEDF348 next to POLE 3. Pole 5 has visible SPLICE CASE H5001. Test and qualify FC1031:754 from MPOE back to HALLS LAKE CO (HLLKWAXX) — FDF 011/33/34. Fiber -Feeder Assignment: FC1031:754back to HALLS LAKE CO on Plant: HLLKWAXX/2100-Bay:FDF01 - M/S: 33- Port: 38 Fiber- Distribution Assignment: H5001:48on por.48 and RED JUMPERto FC1031:754 on port 10 TRUNKING SCHEMATIC: HLLK FTTCS FTTP sheet 3C I CERTIFY THAT THE WORK I COMPLETD ON THIS WORK ORDER AND AS -BUILT IS IN COMPLIANCE WITH FRONTIER QUALITY STANDARDS AS IDENTIFIED ON THE IPQIP CHECKLIST. (SIGNATURE AND DATE TOTALALLOTTED HOURS CONTACT SUPERVISOR IF ADDITIONAL HOURS ARE REQUIRED TO COMPLETE PROJECT CAP. X-TIME MAINT CREW 0 0 0 SPLICING 0 0 0 W.O. DRIVER CONSTRUCTION START IN ETHERNET 03/31/23 ❑ CIAC IN SERVICE DATE ❑ DAMAGE 06/09/23 ❑ OTHER CONSTRUCTION ❑ FLAGGING ❑ BRUSHING ❑ CONTRACTOR PERMITS MUNICIPALITY: CITY OF EDMONDS ❑ BLANKET ❑ TCP/TRAFFIC ® DETAILED (NOT BLANKET) ❑ NO PERMIT REQUIRED JOINT POLE JFN/NJUNS# in NO JPN REQUIRED POLE JPN JPN OWNER TO FROM ❑ ❑ ® POWER ❑ ❑ ❑ CATV ❑ ❑ ❑ FRONTIER ACCOUNT CODES ❑ 2411.001 POLES ® 2422.201 UG FIBER ❑ 2421.101 OH COPPER in2441.001 CONDUIT M 2421.201 OH FIBER ❑ 34XX.XXX REMOVAL ❑ 2422.101 UG COPPER ❑ 64XX.XXX MAINT. JOE BREWER 713-705-7703 EMAIL: JOE PH. BREWER@PROVIDENCE.ORG SCHEDULING: JOHN WOOD PHONE: 425-261-1412 ENGINEER: MIKE HAKAHAN PHONE: 425-949-0230 FACILITIES: SHAWN CONKLIN PHONE: 425-263-4010 FIELDED BY: N/A T: 1,4'HY: K Tip is is a Carrie r order for 10OPv1 service from T' P:1E b^DARNER TELECOM fcr P ROV :DEN CE HEALTH & S ERV I CES, 21822 75- AVE W, EDMONDS, WA 98026. F1 ri+ Er1mr,. ds, WA to FRONTIER DPP E S found r,R 76"-AVE lAi eFth of 2202 ` CT SW. The Tr.rR al tail DRFTR/ENG: MICHELLE SCHAEDLER PHONE: 208-946-8828 ziplyfiber IHLLK - 100M PROVIDENCE HEALTH I 21822 76TH AVE W, EDMONDS, WA NUMBER: 5520227 EXC1 CODE_51419 DRAWN DATE: ENGR: M. HAKAHAN CINTY: SNOHOMISH 3/16/23 PHONE:425-949-0230 FILE: SCALE: 1:100 TAX DISTRICT: DWG 1 OF 3 TWNSHP: RING: SEC: 1N3W1HVdHG S301A2J3S 1N3Wd0E3A30 SONOW03 d0 A_U0 EZOZ 60 ABA gncgm 685 08.2008 RBN 48 HLLKWAXX FC1031,745-774+ XD,31-48 H 762 08.2008 RBN 0 HLLKWAXX H5001,1-144 0 I 1 I � I � I 1 I 1 ----------------- \HLLKWAXX H5001 FDH 48/432 S20A IN: HLLKWAXX FC1031,745-747+ RED FIBER XD,97-439+ JUMPER HLLKWAXX FC1031,748-756 OUT: HLLKWAXX H5001,1-432 215TH ST SW FC1031,754 — — _ _ — — — _ _ TO �`------ — — — — — — H5001.48------ �- I I I I III III I I ® IIIII � I � IIjjIII � � j III jll � I ICI III � � 1N3W12JVd30 S301A2:GS 1N3WdO`l3A3C SONONO3 JO.LL1O £Z0Z 60 AeA 9 n s7im I CERTIFY THAT THE WORK I COMPLETD ON THIS WORK ORDER AND AS -BUILT IS IN COMPLIANCE WITH FRONTIER QUALITY STANDARDS AS IDENTIFIED ON THE IPQIP CHECKLIST. (SIGNATURE AND DATE) TOTALALLOTTED HOURS CONTACT SUPERVISOR IF ADDITIONAL HOURS ARE REQUIRED TO COMPLETE PROJECT CREW 1 0 0 1 0 SPLICING 1 0 0 1 0 W.O. DRIVER CONSTRUCTION START ® ETHERNET 03/31/23 ❑ CIAC IN SERVICE DATE ❑ DAMAGE 06/09/23 ❑ OTHER CONSTRUCTION ❑ FLAGGING ❑ BRUSHING ❑ CONTRACTOR PERMITS MUNICIPALITY: CITY OF EDMONDS ❑ BLANKET ® TCP/TRAFFIC ® DETAILED (NOT BLANKET) ❑ NO PERMIT REQUIRED JOINT POLE JFN/NJUNS# ❑ NO JPN REQUIRED POLE JPN JPN OWNER TO FROM ❑ ❑ ® POWER ❑ ❑ ❑ CATV ❑ ❑ ❑ FRONTIER ACCOUNT CODES ❑ 2411.001 POLES ® 2422.201 UG FIBER ❑ 2421.101 OH COPPER ❑ 2441.001 CONDUIT ® 2421.201 OH FIBER ❑ 34XX.XXX REMOVAL ❑ 2422.101 UG COPPER ❑ 64XX.XXX MAINT. JOE BREWER 713-705-7703 EMAIL: JOEPH.BREWER@PROVIDENCE.ORG SCHEDULING: JOHN WOOD PHONE: 425-261-1412 ENGINEER: MIKE HAKAHAN PHONE: 425-949-0230 FACILITIES: SHAWN CONKLIN PHONE: 425-263-4010 FIELDED BY: N/A I ziplv�fiber HLLK - 100M PROVIDENCE HEALTH 21822 76TH AVE W, EDMONDS, WA PROJECT 5520227 C.O. AREA: 32 NUMBER: EXCH. CODE: 51419 DRAWN DATE: I ENGR: M. HAKAHAN NTY. SNOHOMISH 3/16/23 PHONE:425-949-0230 FILE: SCALE: 1:100 ITAX DISTRICT. IDWG 2 OF 3 TWNSHP: RNG: SEC: SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM LEGEND: OS SIGNALIZED INTERSECTION OCONE (CANDLESTICK) TYPE III BARRICADE WORKTRUCK WORK ZONE LIMITS OWE WARNING SIGN ARROW BOARD REQUIRED) (WHERE DIRECTION OF TRAFFIC (NOT PAVEMENT MARKINGS) FLAGGER-SPOTTER FLAGGER STATION IT- ATCO COMMUNICATIONS SERVICES, LLC AS THE DESIGNER OF THIS TRAFFIC CONTROL PLAN, MAKES NO REPRESENTATION AS TO ITS' GENERAL ADEQUACY OR BEING APPROVED FOR IMPLEMENTATION. APPROVAL MUST RESULT FROM THE TRAFFIC ENGINEER OR OTHER PUBLIC OFFICIAL HAVING STATUTORY ENFORCEMENT AUTHORITY IN THE JURISDICTION. UTILIZATION AND IMPLEMENTATION OF THIS PLAN SHALL BE A RESULT OF THE APPROVAL. REF. MUTCD 2009 6A - 01 (10) SIGN LEGEND: ROAD RIGHT LANE WORK CLOSED AHEAD AHEAD W20-1 W20-5R W20-1J W20-5R/ I / C~ to W20-1 BUFFER AREA LONGITUDINAL BUFFER SPACE = B POSTED SPEED (MPH) 25 30 35 40 45 50 55 60 64 70 LENGTH (feet) 155 200 250 305 360 425 495 570 645 730 TRANSPORTABLE ATTENUATOR ROLL AHEAD DEVICE = R HOST VEHICLE WEIGHT (Ibs) 9,900 TO 22,000 HOST VEHICLE WEIGHT (Ibs) > 22,000 < 45 MPH 45 - 55 MPH > 55 MPH < 45 MPH 45 - 55 MPH > 55 MPH 100, 123' 172' 74' 100, 150' TRAFFIC CONTROL INSPECTION SHALL BE REQUIRED WHENEVER WORK ZONE IS SET UP CENTER LANE CLOSED AHEAD W l -4 L W20-5C W 1-6 R SCHOOL PARKING LOT W1-6R\ \ W1- -4L 76TH AVE W (2 0 MPH) W1 PHASE 1 WORK DETAILS: ACCESS HUB AND RUN RED JUMPER SPOTTER NEEDED FOR PEDESTRIAN TRAFFIC AND DRIVEWAY ACCESS, a z a ° 0000- ° • • • • .. => 0 D/W SIDEWALK N D/W V N D/W NOTE: MON. - FRI. = 7:00am TO 4:00pm CHANNELIZATION DEVICE SPACING (feet) MPH TAPER TANGENT 50/70 40 80 35/45 30 60 25 / 30 20 40 MINIMUM LANE SHIFT TAPER LENGTH = L/2 (feet) LANE POSTED SPEED (MPH) WIDTH (feet) 25 30 35 40 45 50 55 60 65 70 10 55 75 105 135 225 250 275 300 325 350 11 60 85 115 150 250 275 305 330 370 385 12 65 90 125 160 270 300 330 360 390 420 ENGINEERING DIVISION RESU B APPROVED AS NOTED Apr 18 2023 jdl UJ ..f' j,, 4z 07/24/2023 CITY OF EDMONDS VV DEVELOPMENT SERVICES DEPARTMENT SIGN SPACING = X (1) FREEWAY & EXPRESSWAYS 55 / 70 MPH 1500' ± RURAL HIGHWAYS 60 / 65 MPH 800' ± RURAL ROADS 45 / 55 MPH 500' ± RURAL ROADS & URBAN ARTERIALS 35 / 40 MPH 350' ± RURAL ROADS & URBAN ARTERIALS 25 / 30 MPH RESIDENTIAL & BUSINESS DISTRICTS 200' ± (2) URBAN STREETS 25 MPH OR LESS 100'± (2) (1) ALL SPACING MAY BE ADJUSTED TO ACCOMMODATE INTERCHANGE RAMPS, AT -GRADE INTERSECTIONS AND DRIVEWAYS (2) THIS SPACE MAY BE REDUCED IN URBAN AREAS TO FIT ROADWAY CONDITIONS. j"a __N ATCO COMMUNICATIONS SERVICES. LLC www.atcoteiecom.com 360.563.9000 708 First Street Snohomish, WA 98290 ziPylfiber Everett, WA 98206 o Q N 0 d z Q N 0 LU06 N O � N W Q LU _ _ O N N 1y 00 N z O U U LU W m 0 o 7) z U Q U z O cz w LU LU Z Of � U O D- D- DATE: 3.30.2023 REVIEWED BY: D. LAFLEUR WSTCS# 013259 DESIGNED BY: M. LUNA ATCO CONTACT: 606.369.5721 marcus.luna®atcotelecom.com SCALE: SHEET: =5C 02 NO: 2 OF 4 LEGEND: SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM OS SIGNALIZED INTERSECTION OCONE (CANDLESTICK) TYPE III BARRICADE WORKTRUCK WORK ZONE LIMITS OWE WARNING SIGN ARROW BOARD REQUIRED) (WHERE DIRECTION OF TRAFFIC (NOT PAVEMENT MARKINGS) FLAGGER-SPOTTER FLAGGER STATION ATCO COMMUNICATIONS SERVICES, LLC AS THE DESIGNER OF THIS TRAFFIC CONTROL PLAN, MAKES NO REPRESENTATION AS TO ITS' GENERAL ADEQUACY OR BEING APPROVED FOR IMPLEMENTATION. APPROVAL MUST RESULT FROM THE TRAFFIC ENGINEER OR OTHER PUBLIC OFFICIAL HAVING STATUTORY ENFORCEMENT AUTHORITY IN THE JURISDICTION. UTILIZATION AND IMPLEMENTATION OF THIS PLAN SHALL BE A RESULT OF THE APPROVAL. REF. MUTCD 2009 6A - 01 (10) SIGN LEGEND: PHASE 2 ROAD RIGHT LANE CENTER LANE BE WORK CLOSED CLOSED PREPARED AHEAD AHEAD AHEAD (��] TO STOP < > < W20-1 W20-5R Wl-4L W20-5C Wl-6R W20-713 W20-7A R3-2 TRAFFIC CONTROL INSPECTION SHALL BE REQUIRED WHENEVER WORK ZONE IS SET UP 00p0 X W20-7B co hco �o o x c\? W20-7A 4 UPO' at000000 0 � 0 Ww (30 MPH) UNIF❑RMED P❑LICE ❑FFICER IS REQUIRED TO BE ON SITE TO CONTROL THE INTERSECTI❑N WITH THE SIGNAL IN FLASH, CALL CITY INSPECT❑R 48 HOURS PRI❑R TO W❑RKING TO SCHEDULE FLASH ❑PERATI❑NS BUFFER AREA LONGITUDINAL BUFFER SPACE = B POSTED SPEED (MPH) 25 30 35 40 45 50 55 60 64 70 LENGTH (feet) 155 200 250 305 360 425 495 570 645 730 TRANSPORTABLE ATTENUATOR ROLL AHEAD DEVICE = R HOST VEHICLE WEIGHT (Ibs) 9,900 TO 22,000 HOST VEHICLE WEIGHT (Ibs) > 22,000 < 45 MPH 45 - 55 MPH > 55 MPH < 45 MPH 45 - 55 MPH > 55 MPH 100, 123' 172' 74' 100, 150' IBM NOTE: MON. - FRI. = 7:00am TO 4:00pm TRAFFIC HALT NO MORE THEN 5 MIN. ACROSS 76TH ST SW TO ALLOW AERIAL CR❑SSING wl 000000000 OL&L S 00000000OI _ =0000 0000000 .Jo RAISED 7Aco c �o aB m x FLAGGERS WILL HAVE WORK STOP TO ESCORT PEDESTRIANS THROUGH W❑RKZ❑NE SIDEWALK CLOSED •. . WORK DETAILS: ACCESS POLE 5 THEN ❑VERLASH TO POLE 3S2 SPOTTER NEEDED FOR PEDESTRIAN TRAFFIC AND DRIVEWAY ACCESS. i9-9 20-7A a z N❑TIFY BUSINESSES THAT DRIVEWAY ON 76TH R E S U B WILL BE CLOSED, CUSTOMERS NEED TO USE DRIVE WAY ON 220TH (425) 776-7523 ENGINEERING DIVISION APPROVED AS NOTED Apr 18 2023 CHANNELIZATION DEVICE SPACING (feet) MPH F TAPER 7 TANGENT 50/70 1 40 1 80 35/45 30 60 25/30 20 40 MINIMUM LANE SHIFT TAPER LENGTH = L/2 (feet) LANE POSTED SPEED (MPH) WIDTH (feet) 25 30 35 40 45 50 55 60 65 70 10 55 75 105 135 225 250 275 300 325 350 11 60 85 115 150 250 275 305 330 370 385 12 65 90 125 160 270 300 330 360 390 420 CITY OF EDMONDS j�� DEVELOPMENT SERVICES QJ� � 07/24/2023 DEPARTMENT SIGN SPACING = X (1) FREEWAY & EXPRESSWAYS 55 / 70 MPH 1500' ± RURAL HIGHWAYS 60 / 65 MPH 800' ± RURAL ROADS 45 / 55 MPH 500' ± RURAL ROADS & URBAN ARTERIALS 35 / 40 MPH 350' ± RURAL ROADS & URBAN ARTERIALS 25 / 30 MPH RESIDENTIAL & BUSINESS DISTRICTS 200' ± (2) URBAN STREETS 25 MPH OR LESS 100'± (2) (1) ALL SPACING MAY BE ADJUSTED TO ACCOMMODATE INTERCHANGE RAMPS, AT -GRADE INTERSECTIONS AND DRIVEWAYS (2) THIS SPACE MAY BE REDUCED IN URBAN AREAS TO FIT ROADWAY CONDITIONS. O ATCO COMMUNICATIONS SERVICES. LLC www.otcoteiecom.com 360.563.9000 708 First Street Snohomish, WA 98290 ziPylfibeI Everett, WA 98206 I- Q c/) o N 0 z d N 0 W N 06 O � N Lu Lu O N N 00 N z O U U LU w LL m 0 o 7) z U Q U z O c w z � U O CL DATE: 3.30.2023 REVIEWED BY: D. LAFLEUR WSTCS# 013259 DESIGNED BY: M. LUNA ATCO CONTACT: 606.369.5721 marcus.luna®atcotelecom.com SCALE: SHEET: NOT 03 SCALE NO: 3 OF 4 SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM LEGEND: OS SIGNALIZED INTERSECTION OCONE (CANDLESTICK) TYPE III BARRICADE WORKTRUCK WORK ZONE LIMITS OWE WARNING SIGN ARROW BOARD REQUIRED) (WHERE DIRECTION OF TRAFFIC (NOT PAVEMENT MARKINGS) FLAGGER-SPOTTER FLAGGER STATION ATCO COMMUNICATIONS SERVICES, LLC AS THE DESIGNER OF THIS TRAFFIC CONTROL PLAN, MAKES NO REPRESENTATION AS TO ITS' GENERAL ADEQUACY OR BEING APPROVED FOR IMPLEMENTATION. APPROVAL MUST RESULT FROM THE TRAFFIC ENGINEER OR OTHER PUBLIC OFFICIAL HAVING STATUTORY ENFORCEMENT AUTHORITY IN THE JURISDICTION. UTILIZATION AND IMPLEMENTATION OF THIS PLAN SHALL BE A RESULT OF THE APPROVAL. REF. MUTCD 2009 6A - 01 (10) SIGN LEGEND: ROAD RIGHT LANE WORK CLOSED AHEAD AHEAD W20-5R (Italia RAISED 76TH AVE W (30 MPH) CENTER LANE CLOSS> <� ED AHEAD W 1-4 L W20-5C W 1-6 R R3-2 TRAFFIC CONTROL INSPECTION SHALL BE REQUIRED WHENEVER WORK ZONE IS SET UP W1-BR. WI a 8g00000 0000 0 • 00000000 0000000000000000 00,00 000000000 000000000000-6-2-0*0 0 ppO W1-6R WI -SR WI -BR W20-1 W20-5C bib X X W20-1 x � o rn� BUFFER AREA LONGITUDINAL BUFFER SPACE = B POSTED SPEED (MPH) 25 30 35 40 45 50 55 60 64 70 LENGTH (feet) 155 200 250 305 360 425 495 570 645 730 TRANSPORTABLE ATTENUATOR ROLL AHEAD DEVICE = R HOST VEHICLE WEIGHT (Ibs) 9,900 TO 22,000 HOST VEHICLE WEIGHT (Ibs) > 22,000 < 45 MPH 45 - 55 MPH > 55 MPH < 45 MPH 45 - 55 MPH > 55 MPH 100, 123' 172' 74' 100, 150' NOTE: MON. - FRI. = 7:00am TO 4:00pm CHANNELIZATION DEVICE SPACING (feet) MPH TAPER TANGENT 50/70 1 40 1 80 35/45 30 60 25/30 20 40 MINIMUM LANE SHIFT TAPER LENGTH = L/2 (feet) LANE POSTED SPEED (MPH) WIDTH (feet) 25 F 30 35 40 45 50 55 60 65 70 10 55t75 105 135 225 250 275 300 325 350 11 60115 150 250 275 305 330 370 385 12 65 125 160 270 300 330 360 390 420 PHASE 3 WORK DETAILS: a z O UPSIZE PED AND PULL FIBER TO CUSTOMER Q ACCESS POLE 3S2 SPOTTER NEEDED FOR PEDESTRIAN )K TRAFFIC AND DRIVEWAY ACCESS. ANY WORK AFFECTING TRANSIT ❑PERATI❑NS OR FACILITIES CONTACT CIC @ 425-348-7100 ASK FOR C❑NSTRUCTI❑N SUPERVIS❑R PROVIDE ONE WEEK N❑TIFICAI❑N FOR BUS STOP IMPACTS R E S U B ENGINEERING DIVISION APPROVED AS NOTED Apr 18 2023 CITY OF EDMONDS %ill 07/24/2023 DEVELOPMENT SERVICES VV DEPARTMENT SIGN SPACING = X (1) FREEWAY & EXPRESSWAYS 55 / 70 MPH 1500' ± RURAL HIGHWAYS 60 / 65 MPH 800' ± RURAL ROADS 45 / 55 MPH 500' ± RURAL ROADS & URBAN ARTERIALS 35 / 40 MPH 350' ± RURAL ROADS & URBAN ARTERIALS 25 / 30 MPH RESIDENTIAL & BUSINESS DISTRICTS 200' ± (2) URBAN STREETS 25 MPH OR LESS 100'± (2) (1) ALL SPACING MAY BE ADJUSTED TO ACCOMMODATE INTERCHANGE RAMPS, AT -GRADE INTERSECTIONS AND DRIVEWAYS (2) THIS SPACE MAY BE REDUCED IN URBAN AREAS TO FIT ROADWAY CONDITIONS. J"u __N ATCO COMMUNICATIONS SERVICES. LLC www.atcoteiecom.com 360.563.9000 708 First Street Snohomish, WA 98290 ziPylfiber Everett, WA 98206 I. o Q N 0 z d Q N 0 LUot$ N O N W a LU _ _ O N N 00 ry N z U U LU W m0 7)o Q z U Q U z O cz w LU LU z Of D- � C U o DATE: 3.30.2023 REVIEWED BY: D. LAFLEUR WSTCS# 013259 DESIGNED BY: M. LUNA ATCO CONTACT: 606.369.5721 marcus.luna@atcotelecom.com SCALE: SHEET: NOT TO 04 SCALL NO: 4 OF 4 ATCO COMMUNICATIONS SERVICES, LLC AS THE DESIGNER OF THIS TRAFFIC CONTROL PLAN, MAKES NO REPRESENTATION AS TO ITS' GENERAL ADEQUACY OR BEING APPROVED FOR IMPLEMENTATION. APPROVAL MUST RESULT FROM THE TRAFFIC ENGINEER OR OTHER PUBLIC OFFICIAL HAVING STATUTORY ENFORCEMENT AUTHORITY IN THE JURISDICTION. UTILIZATION AND IMPLEMENTATION OF THIS PLAN SHALL BE A RESULT OF THE APPROVAL. REF. MUTCD 2009 6A - 01 (10) Edmonds. School District Stadium Willa Don Apartments' 19 monds Wellness Clinic 4? 215th PI SW a � Park 212 Apartments 9 t7ri14R01U 1UYUL8 CarMax 19, SEAWEED Cannabis Edmonds - Dispensary--- r' McDonald'sip Foreign Carter Acura Se n of Lynnw;.00d R m r I OTC at avv r I nm ax avv 216th St SW f _ Swedish 211v§thStSW -he Golden Leaves Sherman Optical Edmonds CampusP `�. ce " Swedish Urgent ! Salim Gook Jlh•Palace Care - Edmonds ! Edmonds Oral Surgery ° Premera Blue Cross, PHASE 2&3, Building 4 (Orcas) Premier Painting� and Constructiion-�� yPla' 7 Justin Pagan, DDS, MSD° err' ' Dick's' brive-In WinCo Foods;/+r 0 Red Dragon Pok64 J� o 220th St SW PHASE 1 21 Sth St SW 22uth St SW Bailing Lynnwood Honda' 19 Bella Brazilians and Brows 9 Massey Counseling Harbor Freight Doug's Hyundai' 9 222nd Street SW 222nd Street SW larian latian Esperance Doug's Lynnwood Mazda , Park &9 4+ Off Leash Dag Area 223rd St SW C w EL vl 1 220th St // 9 Woods 19 VICINITY MAP Olympic I P if Alpine 4 220th St SW i Evergreen Mass & Welln QExtra 'Space Storag( I? LLdJ Photos N 6 A" O ATCO COMMUNICATIONS SERVICES. LLC www.atcotelecom.com 360.563.9000 708 First Street Snohomish. WA 98290 zi lyfiber P Everett, WA 98206 Q ? LO LO (n o U u a a U z OLf F ~ 2 � � N w « O LO w u LLJ W N o = N C J W 0 U w m U) W � z U o Q U z O ui 2 Q 0� 0� O z J_ d IL _I w DATE: 3.30.2023 REVIEWED BY: D. LAFLEUR WSTCS# 013259 DESIGNED BY: M. LUNA ATCO CONTACT: 606.369.5721 marcus.luna@atcotelecom.com RESUB SCALE: SHEET: Apr 18 2023 N 0 T TO O CITY OF EDMONDS SCALE DEVELOPMENT SERVICES DEPARTMENT 1 OF 4 CITY OF EDMONDS Right -of -Way Application #1292170 - 5520227 RECEIVED APR 03 2023 MyBuildingPermit.com CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT Applicant First Name Last Name Company Name Victoria Comer Ziply Fiber Number Street Apartment or Suite Number E-mail Address 1800 41 ST Street Ste N-100 victoria.comer@ziply.com City State Zip Phone Number Extension Everett WA 98203 (830) 513-6614 Contractor Company Name ZIPLY FIBER NORTHWEST LLC Number Street Apartment or Suite Number 1220 75th St SW City State Zip Phone Number Extension Everett WA 98203 (425) 231-3928 State License Number License Expiration Date UBI # E-mail Address ZIPLYFN782L3 5/25/2024 iyini i4gn caitlin.reid@Ziply.com Project Location Number Street Floor Number Suite or Room Number 21830 76TH AVE W City Zip Code County Parcel Number EDMONDS 98026 00461000200102 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 PROVIDENCE HEALTH & SERVICES WASHINGTON Number Street Apartment or Suite Number 800 5TH AVE 1200 City State Zip SEATTLE WA 98104 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: 3/31/2023 Submitted By: Victoria Comer Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Right -of -Way Application #1292170 - 5520227 Project Contact Company Name: Ziply Fiber Name: Arianne Mommsen Email: Arianne.Mommsen@Ziply.com Address: 1800 41 ST Street Ste Phone #: (830) 513-6614 N-100 Everett wa 98203 Project Type Activity Type Scope of Work Utility Purveyor Utility Work Disturbance of Surface Project Name: 5520227 Description of Work: run red jumper. overlashing, upsize ped small handig from ped to pole Project Details Project Information Job Number 5520227 Page 2 of 2