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ENG2023-0545 ROW PERMITRIGHT OF WAY EUC PERMIT PERMIT NUMBE City of Edmonds :01 145 ww -. •. i Description: PUD - EMERGENCY REPLACEMENT ALREADY COMPLETED NJUNS #5291174 ISSUED: 11/28/2023 Address: 7420 230TH ST SW EDMONDS WA 98026-8528 EXPIRES: 05/28/2024 Permit Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 00441500302500 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 HUMPHREYS GARY B 7420 230TH ST SW, EDMONDS WA 98026-8528 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 1:54:43 PM 1 of 2 RIGHT OF WAY EUC PERMIT PERMIT NUMIJBE 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** E-7 TRAFFIC CTRL Printed: Tuesday, November 28, 2023 1:54:43 PM 2 of 2 RECEIVED of EpM04O� /'V.isa° SECTION A 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 24 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 Replace (i) Depreciated B/O Pole in Edmonds area Site Address or if no site address use Property Address at NW corner of project area: 7420 23oth St SW, Edmonds Associated Permits: BLD PLN ENG Owner and Entity Holding Name of Company Snohomish County PUD #1 Franchise Ordinance No: Point of Contact Andrea Nelson Title Project Manager Address P.O. BOX 1107 City Everett State WA Zip 982o6 Phone 425-512-3526 Email ajnelson@snopud.com and permits@snopud.com Contractor and Authorized Agent of Owner Name of Company SEE 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: Email State License No: 313-005-741 E-K Contractor verifies it is currently bonded EN 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) XUtility 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.) Replace (1) Depreciated B/O POLE Not blocking sidewalk not blocking traffic, can get to parking space. will cone ott work area tor sa ety pole as -already een replaced— wo# 10010 479 o communication a ac emen s- old pole as been remove RIGHT-OF-WAY CLOSURE AREA TOTAL DURATION (Number of Months) Sidewalk 72 hours + LF I x LF SF Alley 72 hours + LF Ix I LF SF Parking 72 hours + LF Ix I LF SF 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 Apower ❑ 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 x No 2. Will any equipment be added underground or above ground (e.. pedestals, vaults, etc.)? x 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? x 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? x 5. Does the work involve proposed additions to an aboveground utility stem? If es: x 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 x project is proposed: 6a. Does your project involve wires/cables/lines? If yes: x How many are existing? 1 1 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: x How many poles are existing in the project area? 1 What is the height of the existing poles? 45 How many poles are to be removed? 1 Are additional poles to be laced? x How many? I I What is the height of the additionalpoles? 6c. Are any poles to be modified/rebuilt/replaced? If yes: x How many? 1 11 What is the height of the poles after? 45 Describe the modification rebuild: replace existing 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: 'R/u N /y DATE: 10/23/23 APPLICANT PRINTED NAME: rea Twelson APPLICANT TITLE: project manager NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021 SEP 2 3 ZC22 PUBLIC UTILITY DISTRICT NO.1 OF SNOHOMISH COUNTY LOCATION 7420 230TH ST SW EDMONDS LYNNWOODAREA POLE NO. 15811 NW1/4S 32 T 27 R 4 DATE 3/24/22 ORDER 100093457 REASON FOR WORK REPLACE BO POLE ENGINEER A.NELSON OPERATION 0030 DRAFTER U.G. NO. SCALE Vw10O' rDATE3/30/22 VED DATE PRINTED DATE WORK COMPLETED Q-l�-ZZ MF 3/31/22 FOREMAN B!2 4 LI FEES REQ'D ❑ YES ■ NO PRIMARY OVERHEAD FO _ EM ❑ RESIDENTIAL otof'Y CO PL ��s �=s D BASIC FEE s MARS & =$ VrTYR"1ddIVV'."P0YlY s PRIMARY UNDERGROUND ❑ RESIDENTIAL AL/ BU11,TCOI�I'sIC FEE s LEU NO. kNG OVIO BY: =s CONDARY UNDERGROUND LYLt �rn ♦ ♦ IL 'Cs =s =s STREET LIGHTING (L FT.0 '=s WORK IN RIGHT OF WAY ❑ PRIMARY ❑ SECONDARY q. FT.03 '=s MISCELLANEOUS FEES VAULT s_ PERMIT s_ s_ s NESC VIOLATIONS ■ NO ❑ YES (SEE NOTES) PERMITS (DATE GRANTED) ❑ TREE TRIM ❑ STATE ❑ COUNTY ■ CITY EDMONDS EASEMENTS ❑ REQUIRED ■ NOT REQUIRED DATE RELEASED FOREIGN CONTACTS ■ JPN• 100093457 EM ❑ JOINT TRENCH ZIPLY & CATV ❑ JOINT BORE ZIPLY & CATV n POLE STENCILING FROM TO TAKE OFF POLE PRE-CONST. REQUIRMENTS ❑ TREE TRIM ❑ PUD LOCATOR ❑ BACKHOE ❑ FLAGGING ■ ONE CALL DATE No. STREET LIGHTING ❑ YES ■ NO _ Kp M&R AS -BUILT TOTAL DUE s DPH GIS DATE PAID DM GIS QC DH M&R RECEIPT NO. DPH GIS Ph JOINT USE SERVICE ORDER NO. LOCATION MAP PAGE LEGEND: O EXISTING POLE X EXISTING POLE -TO BE REMOVED • NEW POLE X NEW POLE TO REPLACE EXISTING POLE SUBSTATION BALLINGER CIRCUIT NO. 12-261 PHASE ENGR'S TEL. e ENGR'S CELLIF—• 425-512-3526 2 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 jdl (NQ✓.J,r Uo4z 11/28/2023 VV RECEIVED OCT 24 2023 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT POLE PLI * 15811 Socu44,,t SET 45" CL 2 POLE (PW2045,NO110), TIGHT WRTH FRAME (12V101) 1 PHASE VERT TANGENT RMV 15 KVA OH XFMR UTC *15-6204 rn v !o _ �_ 24935-1-7 Per SAP 9/27/22 DPH o SER* _��q3�__ HANG )d KVA OH XFMR (12V601) Co Q 2 UTC %333- J SER* J (-Lg5_5_Ll XFR OH SVCS a STRIP, TOP & ENFORCE POLE ATTACHMENT AGREEMENT o a w ALL WORK HAS BEEN COMPLETED. THIS PERMIT IS TO VERIFY THAT THE NEW POLE WAS PLACED IN AN APPROVED LOCATION. N N 0 N i 22903 13 �28 L v 2 22902 I / Q 22907 420 412 228024 2908 0 22911 025-385011 N N 916 ; Q 22915 7419 413 2918 22919 N W 22917 J 0 ar-) 421 Q ' 08L 25-323681 M m 3 -10123 24 SL- 7502-A 0 22925 H R �-r 22925 a 0 . 30 .. O g � ' 22931 0 Z C .0 c.r ------ - - - - ---- - - - - -- f� � 1580 228025 15-3 15810 3 0 R-1304 6-A 15-62 4 25-32 00 -23156 -' �9168 -130415-A 23003 y 188803 S RP 0/3 E 0 25-13185 ' !� 2 426 7420 412 7406 Nam 00 3004 23011 30N 0 c� W I .a mF SHEET OF Jyj _Q �o RECEIVED OCT 24 2023 CITY OF EDMONDS MyBuildingPermit.com CITY OF EDMONDS DEVELOPMENT Right-6MWEA160f6tion #1394206-100106479 (After action req 7420 230th St SW) 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 City Zip Code County Parcel Number Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions)_ Work Location ROW at 7420 230th St SW Property Owner First Name Last Name or Company Name Number Street Apartment or Suite Number City State Zip 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: 10/24/2023 Submitted By: Moe Matthews Page 1 of 2