The URL can be used to link to this page

ENG2023-0379 ROW PERMITOF WAY PERMIT PERMIT ER City •EdmondsRIGHT 121 :01 1 • Sth Ave N, Edmonds WA www.edmondswa.gov i Description: ROW -SEWER REPAIR OVWSD LINE IN CITY ROW ISSUED: 07/25/2023 Address: 9715 241ST PL SW EDMONDS WA 98020-6512 EXPIRES: 01/25/2024 rmit Type: RIGHT OF WAY Permit Subtype: RESIDENTIAL Parcel Number: 00450200000100 i NAME TYPE NAME ADDRESS PHONE APPLICANT TERRY CLINTON 6608 220TH ST SW, MOUNTLAKE TERRACE WA 98043 (206)783-4129 CONTACT FISCHER PLUMBING CO INC, THE 6608 220TH ST SW, MOUNTLAKE TERRACE WA 98043 (206)783-4129 CONTRACTOR FISCHER PLUMBING CO INC, THE 6608 220TH ST SW, MOUNTLAKE TERRACE WA 98043 (206)783-4129 OWNER CHARLES & GEIGER LISA SHIFREN 9715 241ST PL SW, 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 - 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: GRN DATE: 07/25/2023 Printed: Tuesday, July 25, 2023 3:58:12 PM 1 of 2 RIGHT OF WAY PERMIT PERMIT NU �!BEJ City of Edmonds SID www.edmondswa.gov • • CONDITIONS CONDITION TYPE 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 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. • INrTSPECTION TYPE DATE RESULT NOTES COMPLETE X-2 ENGINEERING FINAL** Printed: Tuesday, July 25, 2023 3:58:12 PM 2 of 2 Df EVtfo�� J' RIGHT OF WAY CONSTRUCTION x PERMIT APPLICATION Complete and submit this Application in accordance with the Submittal INC, i sao Requirements outlined in Right -of -Way permit Handout E6st. 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 4.1 Jr 0 Site Address or if no site address use Noperty Address at NW corner of project area: 7 Z S pl„ S Associated Permits: BLD PLN ENG Owner and Entity Holding Franchise (if .pp Name of Company t l e y Franchise Ordinance No: Point of Contact Title ' Address00 City O State Zip Phone d .r Email Contractor and Authorized Agent of Owner (see note below) Contractor Contacts During Construction Primary Name n r MQ. MIA Name of Company Agent Name Title Title Mobile Address Email City Ifl L_%f, I StateWfi I Zip Secondary Name Phone Title Email Mto Mobile City of Edmonds Business License No: Email State License No: FilS Contractor verifies it is currently bon ed 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. Type of Development pp ❑ Multifamily residential ❑ Commercial ❑ City project mingle 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 weln ❑ 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) 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.) EMERGENCY SEWER REPAIR IN ROW - SEPARATE PERMIT FROM OVWSD FOR SIDE SEWER 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.F x I.F SF SECTION B - If you are not a utility company performing work in the City ROW, skip to SECTION C. Type of Utility Facilities 1. The work in the right of way is on or for the following type of facilities: ❑ telecommunications ❑ cable ❑ power ❑ gas ❑ water ❑ sewer ❑ storm 11 Details of Work to . Does the utilityowner have existingoverhead infrastructure in the area of work? • 2. Will an equipment be added underground or above round (e.g. pedestals, vaults etc.)? F. If es describe: Does the proposed work connect a lot or commercial development with utilities that serve more than one lot or commercial development? 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? 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. Does your project involve rebuilding or replacing utility equipment which currently serves more 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 ro'ect is Dro osed: 6a. Does your project involve wires/cables/lines? If yes: How many are existing? How many 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 additional oles? 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 authori o bind the owner to this application. Fees. The Applicant is responsible for 1 it fees. APPLICANT SIGNATURE:�723 DATE: `� /I UkA, APPLICANT PRINTED NAME: Y1 #rnio,,A� APPLICANT TITLE: NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021 City of Edmonds Map Title 1. :" rw ," � � • `�; T,�',•-��1.- '-. •.L .*� .-. �r 1 1Lt a .•"*J,� x *'K F r_ - + _�8$•- - R�,'E;`� ti :2L ;. a 15 586 ��• 15-58 •� ' � .�a� �tr ' � � t l ANY CUTS IN NEWLY OVERLAID ASPHALT SHALL INCUR CUT FEES . - AND REQUIRE MINIMUM 20-FOOT e GRIND AND OEVERLAY. J fit• c?rr G�ck' � UV:;�G�t Legend Storm Catch Basins o -_fMWS p Fti••A>t ■ tl lillrfll:n Storm Manholes 0 rI O P%I- IrRtrarhn • Detention Facirities Culvert • 4l;UNc t.l.xa• • Yns o Facility Feature Stoeks rm line aI cw,m •„ ►,,IWI� N:, &I Nq OCUNIY. NO. LYtt wc;Lw 11 Aw 't RIW.,F, M>. PLOP t fORELNE: No- STATE: No- 1 D _ Y�r. EDt10tiD8:''N. PFPlATE 1 Facility lines Storm Ditch Hydrants cow f PRV Valvx 9 11 N Notes 3-.57 63.1 reet 564 A Tt:z map . t� tc.rxrd st+ocwtPut from w, I rd•rewf rr�pFtr� �r:e a A a •ar nrfr•rr,o' cat( UJI84tcrs that Vpewm the wp nut ormiN net x r_cvau. \Scrcatoc_:.ur7lury_Sphera v:Rc.+r o-c erMserci:Ck. A CiTy oT Edmonds THIS 1/.AP IS NOT TO BE USED FOR CESIGN OR CONSTRUCTION .TI R-ON E_roR NEE �. ENGINEERING � -r..+F....... s?fi:. s i+' • �� i:379 MEMO NOTICE Olympic View Water and Sewer District, hereafter referred to as "District", shall not be liable or responsible for the accuracy in designating the location of the sewer stubs either on Its maps or pursuant to verbal representations of the employees or agents of the District. The District, by this notice, Is held harmless from any and all claims, losses and/or damages arising from the erroneous designation of the location of the sewer stub. U) W C �D s� A S 7 9715 241st DI SW - Googm Mr, X 8 https://www.google.com/maps/place/9716+241st+PI+SW,+Edmonds,+WA+98020/@47.78O1772,-122< 971S 241st PI SW Edmonds, Washington IQ G000le SVeet vl w O � p oth ' B.:ukmoe_ I-V" r.44T �T �. �� •'- � e1- - - sir•! �'x - r i0.1 47 a X CITY OF EDMONDS M BuildingPermit.com Right -of -Way Application #1353118 - Lisa Geiger Applicant First Name Last Name Company Name Terry Clinton Fischer Plumbing Co Inc, The Number Street Apartment or Suite Number E-mail Address 6608 220th st sw fpdsl@nwlink.com City State Zip Phone Number Extension Mountlake terrace WA 98043 (206) 783-4129 2065104296 Contractor Company Name Fischer Plumbing Co Inc, The Number Street Apartment or Suite Number 6608 220th ST SW City State Zip Phone Number Extension Mountlake Terrace WA 98043 (206) 783-4129 State License Number License Expiration Date UBI # E-mail Address FISCHPC131 R1 2/22/2024 FD1 D5R75q fpdsl@nwlink.com Project Location Number Street Floor Number Suite or Room Number 9715 241 ST PL SW City Zip Code County Parcel Number EDMONDS 98020 00450200000100 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 Charles & Geiger Lisa F Shifren Number Street Apartment or Suite Number 9715 241 ST PL SW 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: 7/25/2023 Submitted By: Terry Clinton Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Right -of -Way Application #1353118 - Lisa Geiger Project Contact Company Name: Fischer Plumbing Co Inc, The Name: Terry Clinton Email: fpdsl@nwlink.com Address: 6608 220th st sw Phone #: (206) 783-4129 2065104296 Mountlake terrace WA 98043 Project Type Activity Type Single Family Residential Modification Project Name: Lisa Geiger Description of Work: Repair to private side sewer in ROW Project Details Impervious Surface Adding/Replacing less than 2,000 square feet of hard surface Tree Removal There are no significant trees being removed Scope of Work Excavation and Utility Work Page 2 of 2