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ENG2023-0536 ROW PERMITRIGHT OF WAY EUC PERMIT PERMIT NUMBE City of Edmonds :01 136 ww -. •. i Description: PUD - EMERGENCY REPLACEMENT ALREADY COMPLETED NJUNS #5665874 ISSUED: 11/28/2023 Address: 6801 N MEADOWDALE RD EDMONDS WA 98026 EXPIRES:05/28/2024 Permit Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 00513100008401 NAME TYPE NAME orADDRESS 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 EDMONDS CITY OF 250 5TH AVE N, EDMONDS WA 98026 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 W INDEMNITY 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 11:27:53 AM 1 of 2 RIGHT OF WAY EUC PERMIT PERMIT NU �!B E 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** Printed: Tuesday, November 28, 2023 11:27:53 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 20 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: 68o1 N Meadowdale Rd, Edmonds, 98026 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 4702 sustained vehicle damage and was replaced with a similar 4,-,-foot class 2 wood pole. The new pole was buried 6.5 ftEDFNILOOHGZLWKFUXVKFMUMKing streetlight was rehung on new pole. The old pole was left on -site so Ziply and Wave could move their equipment to the new pole. Ziply to remove pole once their equipment has been transferred to new pole. :RUNKDVDOUHDG\EHHQFRPSOH'OLHgnQDQHPHUJHQF\EDVLVVRQRWUDIILF FRQWUROSODQEAIXGLMWKLV DSSOLFDWLRQ 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.g. 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? 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 yes project is proposed: 6a. Does your project involve wires/cables/lines? If yes: yes How many are existing? 1 4 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 additional oles? 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: Vehicle -damaged pole replaced w similar 45ft class 2 wood 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: WG�.G.hrL �L rG�iL DATE: 10/19/2023 APPLICANT PRINTED NAME: William Graham APPLICANT TITLE: Design Engineer NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021 SNONONISN COUNir oPUBLIC UTILITY DISTRICT NO.1 OF SNOHOMISH COUNTY LOCATION 6801 N MEADOWDALE RD LYNNWOOD AREA POLE NO. 4702, GCI-15 NW 1/4S 8 T27 R 4 DATE REASON FOR WORK CAR POLE ENGINEER CURTIS CONFIRMING SKETCH DRAFTER PLI 4702 45' 2001 DATE WORK COMPLETED 6/28/23 FOREMAN McCARTY FEES REO'D ❑ YES ❑ NO PRIMARY OVERHEAD ❑ RESIDENTIAL ❑ COMMERCIAL LEO N0. SECONDARY OVERHEAD NESC VIOLATIONS BASIC FEE s ❑ NO ❑ YES (SEE NOTES) @$ '=$ PERMITS (DATE GRANTED) ❑ TREE TRIM ❑ STATE METER/CONV. POLE s PRIMARY UNDERGROUND ❑ RESIDENTIAL ❑ COUNTY ❑ COMMERCIAL ❑ CITY BASIC FEE s ❑ EASEMENTS LEU NO. ❑ REQUIRED ❑ NOT REQUIRED SECONDARY UNDERGROUND BASIC FEE s DATE RELEASED La 1=$ UNDERGROUND PLAT FOREIGN CONTACTS X JPN# BASIC FEE s FT.@S '=$ ❑ JOINT TRENCH ZIPLY & CATV ❑ JOINT BORE ZIPLY & CATV STREET LIGHTING cL FT.@$ '=$ ❑ POLE STENCILINGFROM WORK IN RIGHT OF WAY TO ❑ PRIMARY TAKE OFF POLE ❑ SECONDARY PRE—CONST. REQUIRMENTS ❑ TREE TRIM ❑ PUD LOCATOR rL FT.@$ '=$ MISCELLANEOUS FEES ❑ BACKHOE ❑ FLAGGING VAULT s ❑ ONE CALL DATE PERMIT s No. STREET LIGHTING S s ❑ YES ❑ NO s RC M&R AS -BUILT $ DPH GIS TOTAL DUE s TLM GIS QC M&R DATE PAID 0000 GIS Ph JOINT USE RECEIPT NO. LOCATION MAP PAGE 435-B7 SERVICE ORDER NO. I FC,FNn: O EXISTING POLE X EXISTING POLE -TO BE REMOVED • NEW POLE NEW POLE TO REPLACE EXISTING POLE APPROVED'-" ' DATE SUBSTATION CIRCUIT N0, ENGR'S TEL. # ENGR'S CELL # ORDER 100116208 OPERATION 0001 U.G. NO. SCALE NTS DATE PRINTED N/A PHASE 13 10 6 4702 REPLACED WITH 45' CLS 2 POLE MFR 2022 REHUNG SL-144280-A OLD POLE STILL IN FIELD 294426 GCI 5 SL-144280-A ALL WORK HAS BEEN COMPLETED. THIS PERMIT IS TO VERIFY THAT THE NEW POLE WAS PLACED IN AN APPROVED LOCATION. 83 D-1z859z-BIL/ 84 232 284229---- SIN 12-4177 GCI-14 SL-129972-A 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 JeR WQ✓..irri,44. 11/27/2023 VV 4700 P 2� 25-30249 GCI-13 802-M SL-129964-A RECEIVED OCT 20 2023 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT 6"OH4>PAIS" �uNrry Ptl�+"C U"'.ft I?1S�tie�t N 11'FFSWAT Crew Incident Information for SWAT Incident S4548354ZC ** 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). S4548354ZC Creation Date: 06/28/2023 Last Modified Date: 1 06/28/2023 Last Modified By: SRV CLICK Work Order Type: Elec Emergency Expense Reimbursable Ordr Order Description: I SWAT ID S4548354ZC *DAMAGE WBS Description: Main Work Center: Generated: 06/29/2023 1:45 PM EMERGENCY WORK AND RESTORA' LYNNWOOD Maintenance Activity: Emergency SAP Work Order Num.: 100116208 Functional Location: P851784 Func. Loc. Name: Pole 4700 Dispatcher Comments: SWAT ID S4548354ZC *DAMAGE CLAIM* Dispatcher comments for SWAT ID S4548354ZC: 6801 N MEADOWDALE RD, MEYER, CAR POLE, POLE GCI-15 IS BROKEN, CREW AND 2 FLAGGERS TO REPLACE 45' POLE GCI-15, SHOULD BE ABLE TO REPLACE HOT 06/28/2023 A claim, DC20205, has been created and work order 100116208 is associated with this claim. Claim is assigned to Greg Galeotti. MJGORMA Operation Work Center Personnel Name 0003 LYN-A2 Daniel McCarty SWAT ID S4548354ZC Created from Click on 06/28/2023 06:57:00 AM Locate # 23254734 COMCAST CABLE Current Status Description OCMP NSTM SWAT ID S4548354ZC CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT Report Name: Crew Incident Information Page 1 of 2 Crew Incident Information for SWAT Incident S4548354ZC *** Note: If this report is not loading for you please contact ITSBI@snopud.com Generated: (or its-bi@snopud.pagerduty.com if after hours and it's urgent). 06/29/2023 1:45 PM CITY OF EDMONDS ZIPLY FIBER CITY OF LYNNWOOD PSE-GAS SNOPUD#1 RECEIVED OCT 20 2023 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT Report Name: Crew Incident Information Page 2 of 2 RECEIVED OCT 20 2023 Project Name: Original WO has been closed; please use 100106479. CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT Scope of Work: Distribution pole was damaged during storm. PUD crews replaced the pole with a similarly sized one (45-foot class 2). Old pole was left in field so Wave and Ziply could transfer their equipment to the new pole. Ziply to remove old pole when equipment has been transferred. No cuts in asphalt were made. Location: Pole is located at 6801 N Meadowdale Rd, Edmonds. (pli 294426) Work area is not in a critical area/wetland/shoreline area. Which lane direction is being closed: (Job has already been worked) Crews would have had to occupy the westbound lane of N Meadowdale Rd to install the new pole. Hours and Duration at the Location: All work was completed on 6/28/2023, in approximately 6 hours. Traffic control plan: This job has already been worked on an emergency basis, so no traffic control plan is included. RECEIVED OCT 20 2023 ':ITY OF EDMONDS M BuildingPermit.com CITY OF EDMONDS DEVELOPMENT Right-afMS9A1Pf1fifion #1392390-100106479 (After action req 6801 Meadowdale I 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 6801 N MEADOWDALE RD City Zip Code County Parcel Number EDMONDS 98026 00513100008401 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 EDMONDS CITY OF Number Street Apartment or Suite Number 250 5TH AVE N City State Zip EDMONDS WA 98026 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: 10/19/2023 Submitted By: Moe Matthews Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Right -of -Way Application #1392390-100106479 (After action req 6801 Meadowdale I 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 6801 Meadowdale Rd) Name: This is one of several emergency pole replacement jobs in Edmonds that have already 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 100116208 is closed so we are using work order Description 100106479 to apply for this permit. A distribution pole was damaged during storm (PLI 4702) so of Work: crews replaced the pole with a similarly sized one (45 food, now PLI 294426). The old pole was left in the field so Wave and Ziply could transfer their equipment to the new pole. Ziply to remove the old pole when equipment has been transferred. No cuts in asphalt were made. Crews would have had to occupy the westbound lane of N Meadowdale Rd to install the new pole. All work was completed 6/28/23 and took approx. 6 hours. Project Details Project Information Job Number 100106479 Page 2 of 2