ENG2023-0506 ROW PERMITOF WAY EUC PERMIT
PERMIT NUMBER
City of Edmonds
EdmondsRIGHT
:i 1 1 1.
www.edmondswa.gov i
Description: PUD - INSTALL RISER AND PEDESTAL ON EX POLE ISSUED: 10/19/2023
Address: 21514 84TH AVE W EDMONDS WA 98026-7303
EXPIRES: 04/19/2024
Permit Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 00373600400411
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 KIMBERLEE MECHAELIS 21514 84TH AVE W, EDMONDS WA 98026-7303
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE - PER PERMIT
$45.00 $45.00
ENG - INSPECTIONS
$252.00 $252.00
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: 10/19/2023
Printed: Thursday, October 19, 2023 9:19:56 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 7:00am 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
A-1 JOB START
E-7 TRAFFIC CTRL
X-2 ENGINEERING FINAL**
Printed: Thursday, October 19, 2023 9:19:56 AM 2 of 2
RECEIVED
of EVA10NV
ANC. 18,30
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.
OCT 06 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.
ME
Owner
Name of Company SNOHOMISH COUNTY PUD NO.1 Franchise Ordinance No: N/A
Point of Contact KARL HAACK
Title DESIGNER
Address 21014 63RD AVE W
City LYNNWOOD State WA Zip 98036
Phone425-238-7372
EmailKJHAACK@SNOPUD.COM & permits@snopud.com
and Authorized Agent of Owner
Name of Company SAME AS ABOVE
(see note below)
DuringContractor Construction
Contractor Contacts
Primary Name CHAD GRAHAM
Agent Name
Title CONSTRUCTION OPERATIONS SUPERVISOR
Title
Mobile 817-726-2944
Address
Email CHAD.GRAHAM@VERRAMOBILITY.COM
City State
Zip
Secondary Name
Phone
Title
Email
Mobile
City of Edmonds Business License No: N/A
Email
State License No: 313-005-741
® Contractor verifies it is currently bonded
® Contractor verifies it currently has general liability insurance
NOTE. ECDC 18.6o. o2o requires that the Application be signed by a licensed and bonded contractor unless otherwise approved by the city
engineer.
❑ Multifamily residential e Commercial ❑ City project
❑ Single family residential subdivision ❑ Single family -other ❑ Industrial
❑ Demo and rebuild or from vacant land?
❑ Other, please specify:
e Utility Franchise Work associated with development (check one of the above boxes as weln
❑ Traffic Control Only (no associated development)
❑ 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.)
INSTALL (1) 3" RISER AND PEDESTAL ON EXISTING POLE LOCATED AT CORNER OF PRIVATE DRIVEWAY BETWEEN 21514 84TH AVE WAND 8402 215TH ST SW.
PARTIAL SOUTHBOUND LANE CLOSURE BETWEEN 215TH ST SW AND 216TH ST SW. UNDERBRUSH TRIMMING AND REMOVAL TO BE PERFORMED BY
CONTRACTOR. SOFT SURFACE WORK, NO TREE TRIMMING, NO PAVEMENT CUT. ALL WORK TO TAKE PLACE BETWEEN THE HOURS OF 8:OOAM-4:OOPM.
PARTIAL SIDEWALK CLOSURE BETWEEN 215TH ST SW AND 216TH ST SW. DETOUR PROVIDED BY PUD. (1) RUN OF 350 KCMIL TO BE RAN IN CONDUIT.
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
Parldng 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 Completed
1. 1 Does the utility owner have existing overhead infrastructure in the area of work?
Yes
YES
No
2. 1 Will any equipment be added underground or above ground (e.. pedestals, vaults, etc.)?
YES
If yes, describe: CONDUIT
YES
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 existingunderground common utilitystem?
N O
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 • • be CompletedNo
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
NO
project is proposed:
6a.
Does your project involve wires/cables/lines? If yes:
YES
How many are existing? 1 o 1 How many are to be added? 1
City of Edmonds ROW construction permit Application --Page 2 of 3 Updated 3/25/2021
6b.
I Does your project involve poles? If yes:
NO
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 poles?
6c.
Are any poles to be modified/rebuilt/replaced? If yes:
YES
How many? I i What is the height of the poles after? SAME
Describe the modification rebuild: INSTALL RISER CONDUIT
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 command 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:
APPLICANT PRINTED NAME:
APPLICANT TITLE:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
9122/23
City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021
O
PUBLIC UTILITY DISTRICT NO.1 OF SNOHOMISH COUNTY
CONSTRUCTION NOTES •
LOCATION 21514 84TH AVE W EDMONDS WA 98026
LYNNWOODAREAOAT
POLE No. PLI 226139 NW1/4S 30 T 27 R 4
DATE 8/11/23
ORDER 100119145
POLE PLI 226139
REASON FOR WORK INSALL NEW RISER PED
ENGINEER K HAACK
OPERATION 0060
INSTALL NEW 10 RISER PED ASSY AS1U705.
FOR VERA
DRAFTER
U.G.
CONNECT LOAD 2KW
SCALEE 1" = 60'
INSTALL NEW SM SEC PED APPROX 2' WEST AS STAKED.
APPROVED
DATE PRINTED
INSTALL (3) 5-POS TERM BARS (T1522).
DATE WORK COMPLETED
DATE
FOREMAN
RUN 50' OF 350 KCMIL AL TPX FROM POLE PLI 226139 TO NEW SM SEC PED.
SUBSTATION
FIVE CORNERS
FEES REQID ■YES El NO
CIRCUIT No.
12-1285 PHASE 123
SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM
PRIMARY OVERHEAD
❑ RESIDENTIAL
❑ COMMERCIAL
LEO NO.
@$ '=$
SECONDARY OVERHEAD
BASIC FEE
@$ _$
METER/CONV.POLE $
PRIMARY UNDERGROUND
❑ RESIDENTIAL
❑ COMMERCIAL
BASIC FEE $
LEU NO.
'@$ =$
SECONDARY UNDERGROUND
BASIC FEE
NESC VIOLATIONS
■ NO ❑ YES (SEE NOTES)
PERMITS (DATE GRANTED)
❑ TREE TRIM
❑ STATE
❑ COUNTY
■ CITY EDMONDS
EASEMENTS
❑ REQUIRED ■ NOT REQUIRED
@$ .=$
UAIL KELLASED
UNDERGROUND PLAT
FOREIGN CONTACTS
BASIC FEE
❑ JPN#
FTAS '-$
❑ JOINT TRENCH ZIPLY & CATV
STREET LIGHTING
❑ JOINT BORE ZIPLY & CATV
WORK IN RIGHT OF WAY
POLE STENCILING
❑ PRIMARY
FROM TO
❑ SECONDARY
TAKE OFF POLE
FT.0
_$
PRE—CONST. REQUIRMENTS
MISCELLANEOUS FEES
❑ TREE TRIM ❑ PUD LOCATOR
VAULT
❑ BACKHOE ■ FLAGGING
■ ONE CALL DATE 8/16/23
PERMIT
$ 635.74
No. 23329122
RISER + PED INSTALL
$ 3,619.28
STREET LIGHTING
$
❑ YES ■ NO
$
M&R
AS -BUILT
$
TOTAL DUE $
4,492.73
GIS
DATE PAID
GIS QC
M&R
RECEPT No.
GIS Ph
JOINT USE
SERVICE ORDER NO.
LOCATION MAP PAGE 454—J6
LEGEND:
o EXISTING POLE
1K EXISTING POLE -TO BE REMOVED
• NEW POLE
)K NEW POLE TO REPLACE EXISTING POLE
ENGR'S TEL. #
425-670-3208
ENGR'S CELL #
425-238-7372
N
215TH ST SW
I I
8152
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.
RECEIVED
OCT 06 2023
i
ENGINEERING DIVISION
APPROVED AS NOTED
CITY OF EDMONDS
DEVELOPMENT%p,� �Q�xp 10/16/2023
SERVICES DEPARTMENT VV
U
21514
21522
EDGE OF
SIDEWALK
8402
O
'21506
OWNER/CONTRACTOR IS RESPONSIBLE FOR
EROSION CONTROLAND DRAINAGE
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
I I I
I I I
I I I
PLI 14425
SL-109352-A
I I I
I I I
I I I --
I I I
I I I
I I i
I I I
37.5-366010
PLI 226139
SL-129568-A _
,
,
W
I I I
I I I = I
,I
I— 21505
00
PLI 14422
, I I
LAYOUT
1" = 60'
21425
PLI 226140
\ I
I
21507
SHEET 1 OF 1
1
L
L�
D
SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM
LANE CLOSURE ON A TWO-LANE ROAD
(TWO FLAGGER OPERATION)
ROAD
W20-1 WORK
AHEAD
x
ONE LANE
W20-4 ROAD
AHEAD
x
W20-7A ��
x
zx
00
NM
x
G20-2 I ROADNWORK
48" x 24"
(OPTIONAL)
RECEIVED
OCT 06 2023
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
-a
f
r
co
0
•❑
,0 0
48" x 24"
iI END
ROADWORK G20-2
X,, (OPTIONAL)
0
0
N
NORTH
I
VICINITY 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.
TRAFFIC CONTROL INSPECTION SHALL BE
Loo REQUIRED WHENEVER WORK ZONE IS SET UP
7
x
im *T,,
W20-7A
x
ONE LANE
i ROAD W20-4
AHEAD
x
ROAD
.a WORK W 2 0 -1
AHEAD
ENGINEERING DIVISION
APPROVED AS NOTED
%dl (A/&g j $.,04i 10/16/2023
vv
W20-78
BE
PREPARED
TO STOP
OPTIONAL IF
40 MPH OR LESS
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)
25
30
1 35
40
45
50
55
60
1 65
70
LENGTH (FEET)
155
200
1 250
305
360
425
495
570
1 645
730
TRANSPORTABLE ATTENUATOR ROLL AHEAD DISTANCE = R
HOST VEHICLE WEIGHT
9,900 TO 22,000 LBS.
HOST VEHICLE WEIGHT
> 22,000 LBS.
< 45 MPH
45.-55 MPH
> 55 MPH
< 45 MPH
45-55 MPH
> 55 MPH
100' 1
123' 1
172'
74' 1
100' 1
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
1 F(`P'nlll__
O
CHANNELIZING DEVICE
r
FLAGGING STATION
PORTABLE SIGN AND SUPPORT
�®
WORK VEHICLE WITH FLASHING
LIGHT
WORK AREA
RECEIVED
CITY OF EDMONDS
Right -of -Way Application #1386515 - WO 100119145
OCT 06 2023
MyBuildingPermit.com
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
21514 84TH AVE W
City Zip Code County Parcel Number
EDMONDS 98026 00373600400411
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
Kimberlee Mechaelis
Number Street Apartment or Suite Number
21514 84TH AVE W
City State Zip
EDMONDS WA 98026-7303
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: 10/6/2023 Submitted By: Moe Matthews
Page 1 of 2
i
CITY OF EDMONDS MyBuildingPermit.com
Right -of -Way Application #1386515 - WO 100119145
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 100119145
Activity Type
Utility Work
Scope of Work
Disturbance of Surface
WO 100119145: PUD crews to install riser and pedestal on existing pole located at corner of
private driveway between 21514 84th Ave W and 8402 215th St SW. There will be a
Description of southbound lane closure on 84th Ave W, between 215th St SW and 216th St SW. Underbrush
Work: trimming and removal to be performed by contactor. No pavement cutting or tree work. Work to
take place between 8am and 4pm. Partial sidewalk closure between 215th St SW and 216th St
SW with detour provided by PUD.
Project Details
Project Information
Job Number
WO 100119145
Page 2 of 2