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ENG2023-0528 ROW PERMITOF WAY EUC PERMIT PERMIT ER City •EdmondsRIGHT 98020 ENG2023-0528 www.edmondswa.gov i Description: PUD - EMERGENCY REPLACEMENT ALREADY COMPLETED NJUNS #5306855 ISSUED: 11/28/2023 Address: 22615 100TH AVE W EDMONDS WA 98020-5953 EXPIRES: 05/28/2024 Permit Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 00540900000100 CONTACTS 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)783-5681 CONTRACTOR SNOHOMISH COUNTY PUD PO BOX 1107, EVERETT WA 98206 (425)783-4353 OWNER ANDREW MADAR 1 218 MAIN ST 209, KIRKLAND WA 98033 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: 11/28/2023 Printed: Tuesday, November 28, 2023 11:22:26 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 X-2 ENGINEERING FINAL** Printed: Tuesday, November 28, 2023 11:22:26 AM 2 of 2 RECEIVED RIGHT OF WAY CONSTRUCTION PERMIT APPLICATION Complete and submit this Application in accordance with the Submittal Requirements outlined in Right-of-Wgy permit Handout E6�. OCT 18 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. SECTION A General • Project Name Emergency car pole Site Address or if no site address use Property Address at NW corner of project area: 22615 looth Ave W, Edmonds, 98020 Associated Permits: BLD N/A PLN N/A ENG N/A Owner and Entity Holding Name of Company Snohomish County PUD applicable) Franchise Ordinance No: N/A Point of Contact William Graham Title Design Engineer Address 1802 75th St SW City Everett State WA Zip 98203 Phone (360)703 1910 Email permits@snopud.com wlgraham@snopud.com Contractor and Authorized Agent of Owner Name of Company SAME AS ABOVE (see note below) Contractor Contacts During Construction Primary Name Agent Name Title Title Mobile Address Email City State Zip Secondary Name Phone Title Email Mobile City of Edmonds Business License No: NSA Email State License No: 313-005-741 pf Contractor verifies it is currently bonded Contractor verifies it currently has general liability insurance NOTE: ECDC18.6o.o2o 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? ❑ Other, please specify: ❑ Utility Franchise Work associated with development (check one of the above boxes as welt ❑ 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 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.) Repair - Pole pli 1472 sustained vehicle damage and was replaced with a similar 45-foot class 2 wood pole. &UHZV~tilde reKXQJthe existing 15N9$RYHUKHDGVVUDQVIRUPHU, and rehung the eandmgd streetlight. The old pole was left equipment has been transferred to new pole. Work has already been completed, on 9/2/22, on an so no traffic control plan is included in this application. RIGHT-OF-WAY CLOSURE AREA TOTAL DURATION (Number of Months) Sidewalk 72 hours + N/A LF x N/A LF N/A SF N/A Alley 72 hours + N/A LF x N/A LF N/A SF N/A Parking 72 hours + N/A LF x N/A LF N/A SF N/A 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 ❑ gas ❑ water ❑ sewer ❑ storm Details of Work to be Completed 1. Does the utility owner have existing overhead infrastructure in the area of work? Yes yes No 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 stem? If es: NO Are the additions for the purpose of serving new commercial development? N/A Are the additions for the purpose of serving a single-family residential subdivision? N A 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 NO project is proposed: 6a. Does your project involve wires/cables/lines? If yes: NO How many are existing? 1 3 1 How many are to be added? o 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? 1 What is the height of the existing poles? 45 ft How many poles are to be removed? 0 Are additional poles to be laced? NO How many? I N/A I What is the height of the additionalpoles? N/A 6c. Are any poles to be modified/rebuilt/replaced? If yes: yes How many? 1 1 1 What is the height of the poles after? 45 ft Describe the modification rebuild: Damaged 45-ft class 2 wood pole replaced w/new similar pole 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: APPLICANT PRINTED NAME: APPLICANT TITLE: William Graham Design Engineer NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE 10/17/2023 City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021 $NO -MISH CWNiv p...... �O PUBLIC UTILITY DISTRICT NO.1 OF SNOHOMISH COUNTY LOCATION 22615 100TH AVE W LYNNWOOD AREA POLE NO. 1472 SW 1/4S 25 T27 R 3 DATE REASON FOR WORK CAR POLE ENGINEER CURTIS CONFIRMING SKETCH DRAFTER PLI 1472 45' 1971 DATE WORK COMPLETED 9/2/22 FOREMAN BAGGETT FEES REQ'D ❑ YES ❑ NO PRIMARY OVERHEAD ❑ RESIDENTIAL ❑ COMMERCIAL LEO NO. SECONDARY OVERHEAD NESC VIOLATIONS BASIC FEE $ ❑ NO ❑ YES (SEE NOTES) @$ I=$ PERMITS (DATE GRANTED) ❑ TREE TRIM ❑ STATE METER/CONY. POLE $ PRIMARY UNDERGROUND ❑ RESIDENTIAL ❑ COUNTY ❑ COMMERCIAL ❑ CITY BASIC FEE ❑ EASEMENTS LEU NO. @$ _$ ❑ REQUIRED ❑ NOT REQUIRED SECONDARY UNDERGROUND BASIC FEE $ DATE RELEASED 1@$ _$ UNDERGROUND PLAT FOREIGN CONTACTS X JPN# BASIC FEE q FT.@$ '=$ ❑ JOINT TRENCH ZIPLY & CATV ❑ JOINT BORE ZIPLY & CATV STREET LIGHTING CE FT.@$ =$ ❑ POLE STENCILING WORK IN RIGHT OF WAY FROM TO ❑ PRIMARY TAKE OFF POLE ❑ SECONDARY PRE—CONST. REQUIRMENTS [I TREE TRIM ❑PUD LOCATOR cE FT.@$ =$ MISCELLANEOUS FEES ❑ BACKHOE ❑ FLAGGING VAULT $ ❑ ONE CALL DATE PERMIT 3 No. STREET LIGHTING $ $ ❑ YES ❑ NO $ RC M&R AS -BUILT DPH GIS TOTAL DUE 3 DM GIS QC DH M&R DATE PAID DPH GIS Ph LW JOINT USE RECEIPT NO. LOCATION MAP PAGE 474-G1 SERVICE ORDER NO. I F(.FNn: O EXISTING POLE X EXISTING POLE -TO BE REMOVED • NEW POLE NEW POLE TO REPLACE EXISTING POLE APPROVED KP DATE 10/07/22 ORDER 100100750 1472 OPERATION 0001 U.G. NO. REPLACED WITH 45' CLS 2 POLE MFR 2022 SCALE NTS DATE PRINTED REHUNG XFMR 15-21408 SERIAL#3057985094 N/A SUBSTATION WSG CIRCUIT NO.12-404 ENGR'S TEL. # ENGR'S CELL # REHUNG SL-131639-H PHASE 3 OLD POLE STILL IN FIELD 1LUU! J *0 2 3 1 15-21408 SCHEMATIC NTS SL-131639-H wm 15-21408 ;4i- L 291785 -142591-C SL-128621-B 0670 120672 *0 ALL WORK HAS BEEN COMPLETED. THIS PERMIT IS TO VERIFY THAT THE NEW POLE WAS PLACED IN AN APPROVED LOCATION. 0 � 01 2 \ j ` C m 16 615 j 4 18-18-�V03 �925 19911 ENGINEERING DIVISION APPROVED AS NOTED jQlVJ��•�tt[1p 11 /21 /2023 RECEIVED OCT 18 2023 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT RECEIVED OCT 18 2023 Project Name: Original WO (100100750) has been closed; please use 100106479. CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT Scope of Work: Distribution pole was hit by a car and damaged. PUD crews replaced the pole with a similarly sized one (45 ft, cl 2), rehung the existing 15kVA transformer, and rehung the existing streetlight. The pole stub was left on -site for comms to transfer equipment to new pole. Location: 22615 100th Ave W, Edmonds. (pli 291785) Work area not in critical area/wetlands, or erosion zone. Which lane direction is being closed: (job has already been worked) Crews would have had to occupy the southbound lane of 100t" Ave W to install the new pole and rehang the existing transformer and streetlight. Hours and Duration at the Location: All work was completed in approximately 10 hours on 9/2/2022. Traffic control plan: This job has already been worked on an emergency basis, so no traffic control plan is included. Original WO called for an A -crew (4-person crew) with 2 flaggers. Curtis, Rodney From: New Equipment Record <Do_Not_Reply_EquipmentRecord@SNOPUD.com> Sent: Friday, September 2, 2022 10:50 AM To: Maps&Records; Risk Management Claims; Ellison, Keith; Rust, Jared; Starkey, Andrew; Baggett, Kevin Subject: New Pole Equipment Record. A new Pole equipment record was created. ER —ID: 2493 Workorder Number: 100100750 030 Foreman: Kevin Baggett Work Date: 09/02/2022 Work Reason: Car Pole/Damage Existing (Old) Equipment Number: 00000003.0000020909 Old Pole Location ID: 1472 Manufacture Year: 2022 Pole Length: 45 Pole Material: DOUGLAS FIR Pole Class: 1 Comments: GPS Latitude: GPS Longitude: No Photos Available. RECEIVED OCT 18 2023 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT 1 &N4oH4 eM131! QourVTY Puusit Um " I?!-Y SWAT ID: Creation Date: Crew Incident Information for SWAT Incident S1095446TG *** Note: If this report is not loading for you please contact ITSBI@snopud.com (or its-bi@snopud.pagerduty.com if after hours and it's urgent). S1095446TG 09/02/2022 Last Modified Date: 1 09/02/2022 Last Modified By: I KDBAGGE Work Order Type: Elec Emergency Expense Reimbursable Ordr Order Description: I SWAT ID S1095446TG WBS Description: Main Work Center: Generated: 09/02/2022 12:38 PM EMERGENCY WORK AND RESTORA LYNNWOOD Maintenance Activity: Emergency SAP Work Order Num.: 100100750 Functional Location: P863115 Func. Loc. Name: Pole 1472 Dispatcher Comments: SWAT I D S1095446TG Dispatcher comments for SWAT ID S1095446TG: 22615 100TH AVE W, EDMONDS Need crew, 2-flaggers, apprentice, vac truck, jack hammer. @ PLI 1472 possible replace 45' class 2 pole. Need to jack hammer around pole to see if it is broken and needs to be replaced or just straightened. Also bring 10' X-arm. Fielded by Flake. Operation Work Center Personnel Name Current Status 0003 LYN-A2 Kevin Baggett ENRT NSTM SWAT I D S1095446TG Created from Click on 09/02/2022 09:50:00 AM Emergency Loc: 22391710. City of Edmonds, Oly Vw Wtr/Swr, PSE, PUD. Description -RECEIVED SWAT I D S 1095446TG OCT 18 2023 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT Report Name: Crew Incident Information Page 1 of 2 RECEIVED OCT 18 2023 CITY OF EDMONDS MyBuildingPermit.com CITY OF EDMONDS DEVELOPMENT Rig titSWMVA16606ation #1391514 - 100106479 (After action req 22615 100th Ave W 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 22615 100TH AVE W City Zip Code County Parcel Number EDMONDS 98020 00540900000100 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 Andrew Madar Number Street Apartment or Suite Number 218 MAIN ST 209 City State Zip KIRKLAND WA 98033 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: 10/18/2023 Submitted By: Moe Matthews Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Right -of -Way Application #1391514 - 100106479 (After action req 22615 100th Ave W Project Contact Company Name: Snohomish County PUD Name: Moe Matthews Email: permits@snopud.com Address: PO Box 1107 Phone #: (425) 783-5681 Everett WA 98206 Project Type Activity Type Scope of Work Utility Purveyor Utility Work No Disturbance of Surface Project 100106479 (After action req 22615 100th Ave W) Name: This is one of several emergency pole replacement jobs in Edmonds that have been worked on an emergency basis without a permit. A traffic control plan is not included because the work is already complete and work order 100100750 is closed so we are using WO 100106479 to apply Description for this permit. A distribution pole, PLI 1472 was hit by a car and damaged so PUD crews of Work: replaced it with a similarly sized one (45 ft, PLI 291785), rehung the existing 15kVA transformer, and rehung the existing streetlight located at 22615 100th Ave W. No cuts in asphalt were made. No boring, no trenching. Crews would have had to occupy the southbound lane of 100th Ave W to install the new pole and rehang the existing transformer and streetlight. Work was completed in approx. 10 hours on 9/2/22. Project Details Project Information Job Number 100106479 Page 2 of 2