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ENG2023-0378 ROW PERMITRIGHT OF WAY EUC PERMIT PERMIT NUMBER City of Edmonds 98020 ENG2023-0378 www.edmondswa.gov i Description: PSE-EXPOSE WIRE BOX AND REPLACE LID IN SR-104 ISSUED: 08/17/2023 Address: 10124 EDMONDS WAY EDMONDS WA 98020-5130 EXPIRES: 02/17/2024 it Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 00610700200200 W NAME TYPE NAME ADDRESS PHONE APPLICANT COURTNEY XIONG 6500 URSULA PL S, SEATTLE WA 98108 (206)348-0676 CONTACT PUGET SOUND ENERGY 6500 URSULA PL S, SEATTLE WA 98108 (206)348-0676 CONTRACTOR PSE/INFRASOURCE 1660 PARK LANE, BURLINGTON WA 98233 (425)466-4771 OWNER MCDONALDS CORP 9792 EDMONDS WAY 421, EDMONDS WA 98020 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: 08/17/2023 Printed: Thursday, August 17, 2023 11:30:57 AM 1 of 2 RIGHT OF WAY EUC PERMIT PERMIT NUMBE3 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** E-7 RESTOR LIMITS Printed: Thursday, August 17, 2023 11:30:57 AM 2 of 2 RECEIVED 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 25 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- Project Name 887033545 - 11950204 Site Address or if no site address use Property Address at NW corner of project area: 10124 Edmonds Way, Edmonds 98020 Associated Permits: BLD PLN ENG X Owner and Entity Holding•• .• - Name of Company Puget Sound Energy Franchise Ordinance No: Point of Contact Courtney Xiong Title Program Maintenance Coordinator Address 6500 Ursula PI S City Seattle State WA Zip 98108 Phone 206-348-0676 Email courtney.xiong@pse.com Contractor and Authorized Agent of Owner Name of Company Puget Sound Energy (see note below) Contractor Contacts During Construction Primary Name John Rockford Agent Name Courtney Xiong Title Corrosion Control Technian Title Program Maintenance Coorndinator Mobile 206-255-2704 Address 6500 Ursula PI S Email john.rockford@pse.com City Seattle State WA Zip 98108 Secondary Name Courtney Xiong Phone 206-348-0676 Title Program Maintenance Coordinator Email courtney.xiong@pse.com Mobile 206-348-0676 City of Edmonds Business License No: Email courtney.xiong@pse.com State License No: PUGETSE032J 1 IR Contractor verifies it is currently bonded R 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? R Other, please specify: Utility Gas Work R 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.) Wire box have been paved over. Need to chip out to have access for our yearly inspection. Wire box lid to be replaced. Wire box located at 20ft S c/I Edmonds Way and 560ft W c/I 100 Ave W. (1) 1 x1 paving cut anticipated. Work duration approximately 4 hours. 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 R 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 existingunderground common utilitysystem? x 5. Does the work involve proposed additions to an aboveground utility system? If es: x 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 • to be Completed Me 6. Does your project involve rebuilding or replacing utility equipment which currently serves more than one lot or commercial development? 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? 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 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: �� K�� DATE: 07/25/2023 APPLICANT PRINTED NAME: Courtney Xiong APPLICANT TITLE: Program Maintenance Coordinator NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021 SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM RECEIVED Jul 25 2023 Job #: 887033545 Date: 7/20/23 Jurisdiction: Edmonds Right of Way Permit? ❑✓ YES ❑ NO Est. Start Date: 08/14/23 Est. Duration: 1 Day PRE -INSPECTION REPORT CITY OF EDMONDS Q pUGET SOUND ENERGY DEVELOPMENT SERVICES DEPARTMENT Address: 10124 Edmonds Way City / Zip: Edmonds 98020 Customer: PM / Insp: Courtney Xiong 206 348 0676 PHONE NUMBER Construction Method WORK DESCRIPTION: Wire box as een paved over. Need to chip out to have access for our yearly inspection. Trenchless ❑ Replace wire box lid. Wire box located at 20' 5 c/1 Edmonds Way & 560' W c/I 100 Ave W Open Trench ❑ New Construct ❑ Duration: Approx. 4 hours. Existing 0 RESTORATION LIMITS TO BE DETERMINED BY CITY ENGINEERING INSPECTOR N ENGINEERING DIVISION • Applicant shall repair/replace all APPROVED AS NOTED damage to utilities or frontage improvements in City right-of-way 5' per city standards that is caused or 08/15/2023 occurs during the permitted project. \� ems* .,. -•Y a ork Area: , Utility patches shall be combined and full width or half 12 Ft width overlay will be required depending on the extent of disturbance. Where utility patches fall entirely within one travel lane, the overlay shall extend to the ' ` centerline of roadway. Where utility patches extend into - both travel lanes then a full width overlay is required. In front of McDonalds Location: 20' S c/I Edmonds Way & 560' W c/I 100 Ave W Duration: Approx. 4 hours r Work Location Size of Cut Surface Type 20' S 'N S of CL Edmonds Way &56" 'E W of CL 100 Ave-W-- 1'x1' Asphalt 'N S of CL & 'E W of CL 'N S of CL & 'E W of CL ❑ FLAGGERS # MPH ❑ TROLLY LINES ❑ BUS STOP # ❑ METER HOODS # ❑ OFFICERS # SPEED LIMIT ❑ TRAFFIC SIGNAL ❑ ARTERIAL ❑ NO PARKS # ❑ Commercial ❑ Altered Commercial ❑ Leak Repair Service Information ❑ Template Bar ❑ Residential ❑ Altered Residential ❑✓ CP Work Diameter Meter EFV Pressure ❑ Bollards 2.5" # ❑ Multi -Family ❑ Replacement Service ❑ Pothole ❑ 5/8" ❑ 250 ❑ 1800 ❑ 6" WC El Bollards 4" # ❑ New Constr. ❑ Main Maintenance ❑ Extension ❑ 11/8" ❑ 425 ❑ 2600 ❑ 2# ❑ Stub ❑ Service Maintenance ❑ 11/4" ❑ 630 ❑ 10,000 ❑ > 5# ❑ FUEL LINE PERMIT NEEDED ❑ Extension ❑ Valve Maintenance ❑ 2" ❑ 1000 Fuel Line Length: ❑ Compete Sery ❑ Cut & Cap Mtr Loc: Fuel Line Diameter: 10124 Edmonds Way, Edmonds 98020 Job# 887033545/ TS-032991 BEFORE — 0 x (: A google.com/maps/@47.7912851,-122.368634,3a,25y,322.06h,81.07Udata=!3m6!ie1[3m4!1suD1906dO2zGcpZJ9gHl8hA!2eO!7il63a4!8i8l92?ent... [}. IA AFTER RECEIVED Jul 25 2023 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT RECEIVED Jul 25 2023 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT TEMPORARY TRAFFIC CONTROL PLAN SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM TRAFFIC CONTROL INSPECTION SHALL BE \\ REQUIRED WHENEVER WORK ZONE IS SET UP �Po9 0 SO- 20 i ^ MOVE BUS STOP 150' NORTH. s� NOTIFY KING COUNTY METRO CONTACTED AT 206-477-1150 FIVE• DAYS IN ADVANCE OF SCHEDULED DATE. -41 • \ SGtL OV3HV o \� •� • Nb0M av0a /� ••� PLACE W20-1 SIGNS ON ALL ADJACENT PUBLIC STREETS �� WHERE TRAFFIC COULD ENTER a �� WORK AREA WITHIN 1050 FEET OF WORK AREA • �� •• *1.ARK 10124 Edmonds Way Edmonds WA 98020 q USA ENGINEERING DIVISION \ APPROVED AS NOTED 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 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 Work area will be 20' SCL of Edmonds Way & 560' WCL of 100th Ave W. 9. If used, place NO -PARK signs 72 hours in advance of the day that the work is to be done. SIGN SPACING MPH "X" 60/65 1000, 45/55 500' 35/40 350' 30 200' 25 100, JX 08/15/2023 VV CHANNELIZATION DEVICE SPACING MPH TAPER TANGENT 55/70 40 80 35/45 30 60 25/30 20 40 RECEIVED Jul 25 2023 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT 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 LEGEND ® WORK PIT ® 28" TRAFFIC CONE TRAFFIC FLOW WORK VEHICLE/ FLASHING LIGHTS SIGN LOCATION RIGHT OF WAY ROW WORK AREA OCHEVRON ARROW BOARD UNIFORMED POLICE OFFICER FLAGGER P,goc Soora e"orgy REV PUGET Designer: Traffic Control Supervisor Safaa AlNeema Sa`aa o 012611 07/25/2023 0 SOUNDNeema N".4128„ Sa(azEaloeema@P e°com Job # ENERGY (425) 398-6077 (425)398 11950204 Project Address: safaa.alneema@pse.com J 10124 Edmonds Way, Edmonds, WA 98020 Order # 887033545 Page 1 OF 1 RECEIVED CITY OF EDMONDS M BuildingPermit.com Jul 25 2023 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT Right -of -Way Application #1352774 - 887033545 - 11950204 Applicant First Name Last Name Company Name Courtney Xiong Puget Sound Energy Number Street Apartment or Suite Number E-mail Address 6500 Ursula PI S courtney.xiong@pse.com City State Zip Phone Number Extension Seattle WA 98108 (206) 348-0676 Contractor Company Name PUGET SOUND ENERGY INC Number Street Apartment or Suite Number 6500 Ursula PL S City State Zip Phone Number Extension Seattle WA 98108 (206) 716-2641 State License Number License Expiration Date UBI # E-mail Address PUGETSE032J 1 3/20/2024 179n 1 M55 courtney.xiong@pse.com Project Location Number Street Floor Number Suite or Room Number 10124 EDMONDS WAY City Zip Code County Parcel Number EDMONDS 98020 00610700200200 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 MCDONALDS CORP Number Street Apartment or Suite Number 9792 EDMONDS WAY 421 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: Courtney Xiong Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Right -of -Way Application #1352774 - 887033545 - 11950204 Project Contact Company Name: Puget Sound Energy Name: Courtney Xiong Email: courtney.xiong@pse.com Address: 6500 Ursula PI S Phone #: (206) 348-0676 Seattle WA 98108 Project Type Activity Type Scope of Work Utility Purveyor Utility Work Disturbance of Surface Project Name: 887033545 - 11950204 Description of Wire box have been paved over. Need to chip out to have access for our yearly inspection. Work: Replace wire box lid. Wire box located at 20ft S c/I Edmonds Way and 560ft W c/I 100 Ave W. (1) 1x1 paving cut anticipated. Work duration approximately 4 hours. Project Details Project Information Job Number 887033545 - 11950204 Page 2 of 2