ENG2023-0401 ROW PERMITOF WAY EUC PERMIT
PERMIT NUMBER
City of Edmonds
EdmondsRIGHT
:i 1 141
www.edmondswa.gov i
Description: PUD - REMOVE 1 BO POLE ISSUED: 09/06/2023
Address: 7315 212TH ST SW EDMONDS WA 98026-7610
EXPIRES: 03/06/2024
Permit Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 00566900500600
I 11-14111 a
NAME TYPE NAME ADDRESS PHONE
APPLICANT MOE MATTHEWS PO BOX 1107, EVERETT WA 98206 (425)783-5681
CONTACT SNOHOMISH COUNTY PUD PO BOX 1107, EVERETT WA 98206 (425)238-7372
CONTRACTOR SNOHOMISH COUNTY PUD PO BOX 1107, EVERETT WA 98206 (425)783-4353
OWNER GAHC4 EDMONDS WA MOB LLC 18191 VON KARMAN AVE, IRVINE CA 92612
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: MAJ DATE: 09/06/2023
Printed: Wednesday, September 06, 2023 3:44:38 PM 1 of 2
RIGHT OF WAY EUC PERMIT
PERMIT NUMBE3
City of Edmonds
,...
Ave N, Edmonds WA•:020 1 141
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
X-2 ENGINEERING FINAL**
Printed: Wednesday, September 06, 2023 3:44:38 PM 2 of 2
RECEIVED
Of EDtit
°tio�, AUG 7 2023
-- — RIGHT OF WAY CONSTRUCTION
PERMIT APPLICATION CITY OF EDMONDS
DEVELOPMENT
Complete and submit this Application in accordance with the Submittal SERVICES DEPARTMENT
INC. ls90 Requirements outlined in Right -of -Way permit Handout E61.
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 WO 100104488
General•
Project Name REMOVE DISPUTED POLE ACROSS FROM PLI 221835
Site Address or if no site address use Property Address at NW corner of project area: 7315 212TH ST SW, EDMONDS WA 98026
Associated Permits: BLD PLN ENG
i Owner and Entity Holding Franchise (if applicable)
Name of Company SNOHOMISH COUNTY PUD NO. 1 Franchise Ordinance No: N/A
Point of Contact KARL HAACK
Title ASSISTANT DESIGNER
Address 21014 63RD AVE W
City LYNNWOOD State WA Zip 98036
Phone425-238-7372
EmailKJHAACK@SNOPUD.COM &permits@snopud.com
Contractor and Authorized Agent of Owner
Name of Company SAME AS ABOVE
(see note below)
Contractor Contacts During Construction
Primary Name SAME AS ABOVE
Agent Name
Title
Title
Mobile
Address
Email
City State
Zip
Secondary Name
Phone
Title
Email
Mobile
City of Edmonds Business License No:
Email
State License No: 313-005-741
a Contractor verifies it is currently bonded
® Contractor verifies it currently has general liability insurance
NOTE: ECDC18.6o.02o requires that the Application be signed by a licensed and bonded contractor unless otherwise approved by the city
engineer.
Type of Development — Check ALL that apply
❑ 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
e Traffic Control Only (no associated development)
e Utility Franchise Work (no associated development)
City of Edmonds ROW construction permit Application --Page 1 of 3 Updated 3/25/2021
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.)
REMOVAL OF (1) DISPUTED WOOD POLE ON THE EAST SIDE OF 74TH AVE WEST, ON THE WEST SIDE OF THE EDMONDS
PROFESSIONAL CENTER. WORK TO BE DONE AS MAINTENANCE. NO TREE TRIMMING REQUIRED, NO PAVEMENT CUT. NO
INSTALLATION OF NEW FACILITIES. PARTIAL SIDEWALK CLOSURE ALONG 74TH AVE W BETWEEN 210TH ST SW AND 212TH ST SW.
ALL WORK TO BE DONE BETWEEN THE HOURS OF 8:OOAM - 4:0013M. APPROX 1 HOUR PARTIAL NORTHBOUND LANE CLOSURE ON
74TH AVE WEST. TRAFFIC CONTROL BY PUD.
ATTN: **JEFF WHATMORE. THIS PERMIT IS ASSOCIATED WITH SHARED SPREADSHEET SENT TO PUD JOINT USE FOR
7315 212TH ST SW (ON 74TH AVE W).**
RIGHT-OF-WAY
CLOSURE
AREA
TOTAL
DURATION
(Number of Months)
Sidewalk 72 hours +
LF
x
LF
SF
N/A
Alley 72 hours +
LF
x
LF
SF
N/A
Parking 72 hours +
LF
x
LF
SF
N/A
SECTION B - If you are not a utility company performing work in the City ROW, skip to SECTIONC.
1. The work in the right of way is on or for the following type of facilities::
❑ telecommunications ❑ cable e power ❑ gas
❑ water ❑ sewer ❑ storm
Details of Work to be CompletedNo
1. Does the utility owner have existing overhead infrastructure in the area of work?
YES
2. Will any equipment be added underground or above ground (e.. pedestals, vaults, etc.)?
NO
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?
NO
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?
NO
5.
Does the work involve proposed additions to an aboveground utility system? If es:
NO
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?
If yes, answer the following questions related to project area, i.e. the actual area in which the
N O
project is proposed:
6a.
Does your project involve wires/cables/lines? If yes:
NO
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:
YES
How many poles are existing in the project area?
a
What is the height of the existing poles?
35'-45'
How many poles are to be removed?
1
Are additional poles to be laced?
No
How many? I I What is the height of the additionalpoles?
6c.
Are any poles to be modified/rebuilt/replaced? If yes:
NO
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: DATE: 7121/23
APPLICANT PRINTED NAME:
APPLICANT TITLE:
HAACK
ASSISTANT DESIGNER
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
po PUBLIC UTILITY DISTRICT NO.1 OF SNOHOMISH COUNTY CONSTRUCTION NOTES •
LOCATION 7315 212TH ST SW. EDMONDS WA 98026 LYNNWOODAREA STRIP AND RMV DISPUTED POLE EAST OF PLI 221835.
POLE NO. PLI 221835 SW1/4520 T 27 R 4 DATE 7/21/23 ORDER 100104488
REASON FOR WORK RMV DISPUTED POLE ENGINEER K HAACK OPERATION 0120 TRANSFER OF UTILITIES. REMOVAL OF POLE AND FINAL RESTORATION TO BE CONSISTENT
FOR CITY OF EDMONDS DRAFTER U.G. No..
SCALE 1" = 40' WITH APPLICABLE POLE ATTACHMENT AGREEMENT(S) AND JOINT OWNERSHIP POLE AGREEMENT.
APPROVED BAS
DATE PRINTED
DATE WORK COMPLETED
FOREMAN
FEES REQID ❑ YES ■ NO
PRIMARY OVERHEAD
❑ RESIDENTIAL
❑ COMMERCIAL
LEO NO.
La '=$
SECONDARY OVERHEAD
BASIC FEE S
�S .-R
METER/CONV.POLE S
PRIMARY UNDERGROUND
❑ RESIDENTIAL
❑ COMMERCIAL
BASIC FEE S
LEU NO.
NESC VIOLATIONS
■ NO ❑ YES (SEE NOTES)
PERMITS (DATE GRANTED)
❑ TREE TRIM
❑ STATE
❑ COUNTY
■ CITY EDMONDS
EASEMENTS
@$ =$
❑ REQUIRED ■ NOT REQUIRED
SECONDARY UNDERGROUND
BASIC FEE S
DATE RELEASED
1@$ -$
UNDERGROUND PLAT
FOREIGN CONTACTS
■ JPN#
BASIC FEE S
q FT,0 _$
❑ JOINT TRENCH ZIPLY & CATV
STREET LIGHTING
❑ JOINT BORE ZIPLY & CATV
FT.0 _$
❑
POLE STENCILING
WORK IN RIGHT OF WAY
FROM TO
❑ PRIMARY
TAKE OFF POLE
❑ SECONDARY
PRE-CONST. REQUIRMENTS
❑ TREE TRIM ❑ PUD LOCATOR
q FT.@$ `_$
MISCELLANEOUS FEES
❑ BACKHOE ■ FLAGGING
VAULT S
■ ONE CALL DATE 7/27/23
PERMIT s
No. 23292119
STREET LIGHTING
$
$
❑ YES ■ NO
S
M&R
AS -BUILT
s
GIS
TOTAL DUE 8
DATE PAID
GIS QC
M&R
GIS Ph
JOINT USE
RECEPT NO.
LOCATION MAP PAGE 455—A6
SERVICE ORDER NO.,
LEGEND:
o EXISTING POLE
X EXISTING POLE -TO BE REMOVED
• NEW POLE
X NEW POLE TO REPLACE EXISTING POLE
DATE 8/2/23
SUBSTATION ESPERANCE
CIRCUIT NO. 12-688 PHASE 1
ENGR'S TEL. #
425-670-3208
ENGR`S CELL #
425-238-7372
21022
N
21026 _ I
I
I �
21034
21034
PLI 221835
T-2934—X OWNER/CONTRACTOR IS RESPONSIBLE FOR
PLI 10162 EROSION CONTROLAND DRAINAGE
C
M
I I
I I
OWNER/CONTRACTOR RESPONSIBLE FOR LOCATING
ALL ON SITE UTILITIES. RELOCATION/REVISION TO ANY
UTILITIES MAY REQUIRE A SEPERATE PERMIT.
I I
I I
I I
I I
I I
� I
i I
I �
I 1
I I
I I
I OI I
I I �'C
�o
� I
I I
I I
I I
I I
I I
I I
I 1
I �
7315
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.
ENGINEERING DIVISION
APPROVED AS NOTED
Jill "J UWQ 08/31/2023
VV
21034
RECEIVED
I
I 7407
50-373566
ECI-1
PLI 10164
SL-130270-A
LAYOUT
1" = 40'
AUG 7 2023
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
SHEET 1 OF 1
LANE CLOSURE ON A TWO-LANE ROAD
(TWO FLAGGER OPERATION)
*>x-
ONE
W20-1
LANE
W20-4 ROAD
AHEAD
x
� s
W20-7A
x
zQ
00
00
CV M
-a
f
— -mr LiJ
a
r =
H
d-
x
G2 0 - 2 I ROADNWORK
48" x 24"
(OPTIONAL)
ENGINEERING DIVISION
APPROVED AS NOTED
%l/ iA/Q.iX H. inp 08/31 /2023
vv
48" x 24"
im END G20-2
ROAD WORK
X,, (OPTIONAL)
0
0
N
NORTH
I WORK
SITE
VICINTY MAP
SIGN SPACING = X
FREEWAYS & 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
RESIDENTIAL & BUSINESS DISTRICTS
25-30 MPH
200'± (2)
URBAN STREETS
1 25 MPH OR LESS
100'± (2)
(1) ALL SPACING MAY BE ADJUSTED TO ACCOMMODATE INTERCHANGE
RAMPS, AT -GRADE INTERSECTIONS AND DRIVEWAYS.
(2) THIS SPACING MAY BE REDUCED IN URBAN AREAS TO FIT
ROADWAY CONDITIONS.
r LO
7
x
.m •� W20-7A
X
ONE LANE
AL ROAD W20-4
AHEAD
x
ROAD
i WORK W20-1
AHEAD
W20-78
DE
PREPARED
TO STOP
OPTIONAL IF
40 MPH OR LESS
RECEIVED
AUG 7 2023
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
THIS PLAN MAY BE MIRRORED FOR
OPPOSITE SIDE OF ROADWAY USING
SAME SIGNS AND SPACING.
YES ■ NO ❑ INITIAL KJH
GENERAL NOTES:
1. ALL SIGNS AND SPACING SHALL CONFORM TO THE MUTCD.
2. NOTIFY LOCAL EMERGENCY SERVICES OF CLOSURE TIMES AND
DATES (OPTIONAL).
3. SIGN SPACING MAY BE REDUCED IN URBAN AREAS TO FIT ROAD
CONDITIONS.
4. PROTECTIVE VEHICLE RECOMMENDED -MAY BE A WORK TRUCK.
5. ALL SIGNS MINIMUM 48" X 48", UNLESS OTHERWISE SPECIFIED.
6. CHANNELIZATION DEVICES ARE 28" REFLECTIVE CONES. SEE TABLE 1
FOR SPACING DISTANCES.
7. ALL SPACING MAY BE ADJUSTED TO ACCOMODATE AT -GRADE
INTERSECTIONS AND/OR DRIVEWAYS.
BUFFER DATA
LONGITUDINAL BUFFER SPACE = B
SPEED (MPH)
1 25
1 30
1 35
1 40
1 45
50
55
1 60
65
70
LENGTH (FEET)l
155
1 200
1 250
1 305
1 360
425
495
1 570
645
730
TRANSPORTABLE ATTENUATOR ROLL AHEAD DISTANCE = R
HOST VEHICLE WEIGHT
9,900 TO 22,000 LBS.
HOST VEHICLE WEIGHT
> 22,000 LEIS.
< 45 MPH
45-55 MPH
> 55 MPH
< 45 MPH
45-55 MPH
> 55 MPH
100'
123' 1
172'
74'
100'
150'
TABLE 1
CHANNELIZATION DEVICE
SPACING (FEET)
MPH
TAPER
TANGENT
50-65
10 TO 20
80
35-45
10 TO 20
60
25-30
10 TO 20
40
I rnpwn-
O
CHANNELIZING DEVICE
r
FLAGGING STATION
i
PORTABLE SIGN AND SUPPORT
�®
WORIT VEHICLE WITH FLASHING
LIGWORK
AREA
RECEIVED
CITY OF EDMONDS
Right -of -Way Application #1358812 - WO 100104488
AUG 7 2023
MyBuildingPermiit. co. —
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
Applicant
First Name Last Name Company Name
Moe Matthews Snohomish County PUD
Number Street Apartment or Suite Number E-mail Address
PO Box 1107 permits@snopud.com
City State Zip Phone Number Extension
Everett WA 98206 (425) 783-5681
Contractor
Company Name
Owner
Number Street Apartment or Suite Number
City State Zip Phone Number Extension
State License Number License Expiration Date UBI # E-mail Address
Project Location
Number Street Floor Number Suite or Room Number
7315 212TH ST SW
City Zip Code County Parcel Number
EDMONDS 98026 00566900500600
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
GAHC4 EDMONDS WA MOB LLC
Number Street Apartment or Suite Number
18191 VON KARMAN AVE
City State Zip
I RVI N E CA 92612
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: 8/7/2023 Submitted By: Moe Matthews
Page 1 of 2
i
CITY OF EDMONDS MyBuildingPermit.com
Right -of -Way Application #1358812 - WO 100104488
Project Contact
Company Name: Snohomish County PUD
Name: Karl Haack Email: kjhaack@snopud.com
Address: PO Box 1107 Phone #: (425) 238-7372
Everett WA 98206
Project Type
Utility Purveyor
Project Name: WO 100104488
Activity Type
Utility Work
Scope of Work
Disturbance of Surface
WO 100104488: Attn: Jeff Whatmore. This permit request is associated with the shared
Description of spreadsheet sent to PUD Joint Use for 7315 212th St SW (on 74th Ave W). PUD crews to
Work: remove pole on east side of 74th Ave W. No tree work. Partial sidewalk closure along 74th Ave
W between 210th St SW and 212th St SW. Work to be completed between 8am and 4pm.
Approximately 1-hour partial northbound closure on 74th Ave W.
Project Details
Project Information
Job Number
WO 100104488
Page 2 of 2