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ENG2023-0452 ROW PERMITOF WAY MINOR PERMIT PERMIT ER City •EdmondsRIGHT Edmonds98020 ENG2023-045 www.edmondswa.gov i Description: ROW -STAGING DUMPSTER FOR SIDING PROJECT ON SFR ISSUED: 10/06/2023 Address: 802 MAIN ST EDMONDS WA 98020-3034 EXPIRES: 04/03/2024 Permit Type: RIGHTOF WAY MINOR Permit Subtype: RESIDENTIAL Parcel Number: 00434207700101 NAME TYPE NAME ADDRESS PHONE APPLICANT CASSANDRA TARTABULL 14724 BOTHELL WAY NE, SEATTLE WA 98155 (206)887-9405 CONTACT PACIFIC EXTERIORS LLC 14724 BOTHELL WAY NE, SEATTLE WA 98155 (206)887-9405 CONTRACTOR PACIFIC EXTERIORS LLC 14724 BOTHELL WAY NE, LAKE FOREST PARK WA 98155 (425)319-7839 OWNER JEAN GILMORE PO BOX 3082, EDM0NDS WA 98020 FEE INFORMATION DESCRIPTION AMOUNT PAID CITY TECHNOLOGY FEE - PER PERMIT $45.00 $45.00 RIGHT OF WAY DISRUPTION FEE $323.35 $323.35 RIGHT-OF-WAY PERMIT -MINOR $126.00 $126.00 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: 10/06/2023 Printed: Friday, October 06, 2023 5:24:41 PM 1 of 2 RIGHT OF WAY MINOR PERMIT L PERMIT NUMBE 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 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 COMPLETE X-2 ENGINEERING FINAL" Printed: Friday, October 06, 2023 5:24:41 PM 2 of 2 RECEIVED .1 of EVA40 G d• INC. 1690 SECTION A RIGHT OF WAY CONSTRUCTION PERMIT APPLICATION Complete and submit this Application in accordance with the Submittal Requirements outlined in _% 1' J• AUG 29 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 (� ` Z ' I �V►0 r� Site Address or if no site address use Property Address at NW corner of project area: 0Z AlAl h �, O ! h Ayc S Associated Permits: BLD PL V ENG Owner and Entity Holding Name of Company Franchise Ordinance No: Point of Contact kA Title Address A City State Zip Phone Email ContractorandAuthorized Name of Company l a 1 Agent of Owner (see Ors note below) `/• V Contractor Contacts During Construction Primary Name �n Oo Agent Name A a�, « Title Y- Title V rn A e Mobile 7 Address -m 'I WO N F Email V City SWa 16 State WA I Zip S5 Secondary Name Phone Title Email CA4 aGl '„' or 1 jrewi Mobile City of Edmonds Business Li nse No: _ 02.bnf Email State License No: L q 1-7 Nk Contractor verifies it is currently bonded A Contractor verifies it currently has general liability insurance NOTE: ECDC i8.6o.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 KSingle family -other o Industrial ❑ Demo and rebuild or from vacant land? ❑ Other, please specify: s i'9it, 4M, ly h,0 n't ❑ 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 t of 3 Updated 3/25/2021 o" ❑ Utility Franchise Work (no associated development) DescriptionProject 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.) 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 + LF x LF SF p� SECTION S - 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 power ❑ gas ❑ water ❑ sewer storm Details of Work to be Completed Does the utilitv owner have existing overhead infrastructure in the area of work? Yes No 2. Will any equipment be added underground or above ground (e.g. pedestals,vaults. etc.)? If �,es describe: 3. 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 stem? 5. Does the work involve proposed additions to an aboveground utility system? If yes: 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. 1 Does your project involve rebuilding or replacing utility equipment which currently serves more 77 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 roject is proposed: 6a. Does your project involve wires/cables/lines? If yes: How mans, are existing? I i How mangy• are to be added? 6b. I Does your project involve poles? If yes: How mane 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 placed? How many? I I What is the height of the additional poles? 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 authority to bind the owner to this application. Fees. The Applicant is responsible fo 11 permit fees. APPLICANT SIGNATURE: DATE: Z 2 z APPLICANT PRINTED NAME: r' 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 9.7 n r s D CALI - j 1 7 z I 00 ca I t s — -- n_ ENGINEERING DIVISION - -,r- - ,�r. "DTED 0/06/2023 ACTOR IS RESPONSIBLE FOR - COj TROL AND D Al GE I l RESP IBLE FOR LOCATING RELOCATION/REVISION 1�0 ANY REQUIRE A-SEPERATE P = — ER SIOfJ — OWNER/CONTRACTOR ALL ON SITE UTILITIES. UTILITIES -MAY I i Applicant all repaidreplace dama improveme is in per city Stan ards occurs during II nor frnntag _ ity right-of-w y at is cause or tted project. . 2U23�— AUG 29 CITY OF EDMONDS j� C 1 DEVELOPMENT _ DEPARTMENT !SERVICES I RECEIVED CITY OF EDMONDS Right -of -Way Application #1366692 - 9762: Gilmore MyBuildingPermi1:.coM'UG 29 2023 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT Applicant First Name Last Name Company Name Cassandra Tartabull Pacific Exteriors LLC Number Street Apartment or Suite Number E-mail Address 14724 Bothell Way NE cassandra@pacificexteriorsllc.com City State Zip Phone Number Extension Seattle WA 98155 (206) 887-9405 Contractor Company Name Pacific Exteriors LLC Number Street Apartment or Suite Number 14724 Bothell Way NE City State Zip Phone Number Extension Lake Forest Park WA 98155 (425) 319-7839 (206) 877-7518 State License Number License Expiration Date UBI # E-mail Address PACIFEL917NK 3/27/2025 Rn9Rs91 iq cassandra@pacificexteriorsllc.com Project Location Number Street Floor Number Suite or Room Number 802 MAIN ST City Zip Code County Parcel Number EDMONDS 98020 00434207700101 Associated Building Permit Number Tenant Name 9762: Gilmore Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Jean Gilmore Number Street Apartment or Suite Number PO BOX 3082 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: 8/29/2023 Submitted By: Cassandra Tartabull Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Right -of -Way Application #1366692 - 9762: Gilmore Project Contact Company Name: Pacific Exteriors LLC Name: Cassandra Tartabull Email: cassandra@pacificexteriorsllc.com Address: 14724 Bothell Way NE Phone #: (206) 887-9405 Seattle WA 98155 Project Type Activity Type Scope of Work Single Family Residential Street Use Objects Temporary in Nature Project Name: 9762: Gilmore We need to stage the portable toilet and dumpster on 8th ave s for a siding Description of Work: project. Project Details Project Start Proposed start date 8/29/2023 Project End Proposed end date 9/7/2023 Page 2 of 2