ENG2023-0587 ROW PERMITRIGHT OF WAY EUC PERMIT
PERMIT NU �!B E
City of Edmonds
98020 - EENG2023-05871
LM
www.edmondswa.gov i
Description: PUD-EMERGENCY POLE REPLACEMENT; ALREADY DONE NJUNS #5719475
ISSUED: 11/30/2023
Address: 923 MAPLE ST EDMONDS WA 98020-3330
EXPIRES: 05/30/2024
Permit Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 00434206903200
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 JORDAN D & BARBARA T KOSTELYK 923 MAPLE ST, EDMONDS WA 98020
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: 11/30/2023
Printed: Thursday, November 30, 2023 9:14:28 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: Thursday, November 30, 2023 9:14:28 AM 2 of 2
RECEIVED
of EpM04O�
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�.
Nov 13 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 Bad order pole replacement
Site Address or if no site address use Property Address at NW corner of project area: 923 Maple Way, Edmonds, 98020-3330
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 955 was deteriorated and replaced with a similar 45-foot class 2 wood pole. The new pole (pli
29461o) was buried 6.5 ftEDFNILOOHGZLWKFUXVKLaIvs also rebuilt the 3-inch secondary riser PUD crews
topped the old pole and left it on -site to allow Ziply and Comcast to transfer their equipment to the new pole.Ptme
crews also replaced the existing overhead primary and neutral copper conductors with new #2 ACSR conductors,
between the new pole and the pole to the west.:RUNKDVDOUHDG\EHHQFRPSOHBWGRQRQDQHPHUJHQF\EDVLV
VRQRWUDIILFFRQWUROk VKLVDSSOLFDWLRQ
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
es
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?
y es
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
yes
project is proposed:
6a.
Does your project involve wires/cables/lines? If yes:
yes
How many are existing? 1 2 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?
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: Deteriorated 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 SIGNATE
APPLICANT PRINTED
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
SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM
REV 1 AUG 1 8 Toz3
PUBLIC UTILITY DISTRICT N0.1 OF SNOHOMISH COUNTY
LOCATION 923 MAPLE WAY LYNNWOODAREA
POLE No. 955 SE1/4S 24 T 27 R 03 DATE 7/7/2023 ORDER 100092667
REASON FOR WORK REPLACE BO POLE ENGINEER A. RIFE OPERATION 0030
DRAFTER U.G. NO.
SCALE 1" = 100'
APPROVED{
DATE 7/7/2023 DATE PRINTED
DATE WORK COMPLETED MF 7/7/23
FOREMAN , //XF%
FEES REO'D ❑ YES ■ NO
PRIMARY OVERHEAD
❑ RESIDENTIAL
❑ COMMERCIAL
LEO NO.
SECONDARY OVERHEAD
BASIC FEE s
'@s =s
T R/CONV. POLE s
�NPLRGROUN7 —"'--
COMMERCIAL AN u0py
FEE 3
�sL & RVTU—R
WF
`�NDE
`� BAsic:�
UNDERGROUND PLAT
BASIC FEE s
ri FT.@s =s
STREET LIGHTING
q FT.Cs '=S
WORK IN RIGHT OF WAY
S-BVII.T
vs
MISCEERAIQMOS,''R�VED BY:
ZIPiyREp VAULT s
(PRINT NAMES s
DAB
TOTAL DUE s
DATE PAID
RECEIPT NO._
SERVICE ORDER NO.
I FI;FNn:
NESC VIOLATIONS
■ NO ❑ YES (SEE NOTES)
PERMITS (DATE GRANTED)
❑ TREE TRIM
❑ STATE
❑ COUNT
■ CITY
O
MNTS
I ED ■ NOT REQUIRED
DATE RELEASED
rORETGN CONTACTS
■ JPN# 100092667 EM
❑ JOINT TRENCH ZIPLY & CATV
❑ JOINT BORE ZIPLY & CATV
POLE STENCILING
FROM TO
TAKE OFF POLE
PRE- ONST. REQUIRMENTS
❑ THE TRIM ❑ PUD LOCATOR
❑ BAC HOE ❑ FLAGGING
■ ONE CALL DATE 6/98/93
STR T LIGHTING
-6-*& ■ NO
F P&R AS -BUILT
DP GIS
DM GIS QC DH M&R
DPH G►S Ph EM JOINT USE
LOCATION MAP PAGE 454 G
RECEIVED
O EXISTING POLE Nov 13 2023
X EXISTING POLE -TO BE REMOVED CITY OFEDMONDS
DEVELOPMENT SERVICES
• NEW POLE DEPARTMENT
)1( NEW POLE TO REPLACE EXISTING POLE
SUBSTATION WSG
CIRCUIT NO. 12-404 PHASE 1
ENGR'S TEL. #
425-783-8559
ENGR'S CELL #
425-239-8210
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.
TRANSFER OF UTILITIES, REMOVAL OF POLE AND FINAL RESTORATION TO BE CONSISTENT
WITH APPLICABLE POLE ATTACHMENT AGREEMENT(S) AND JOINT OWNERSHIP POLE AGREEMENT.
W
Q
rOA PLI 955, NEW PLI # --------------
SET 45 CL2 POLE W/GND TIGHT EAST (PW2045, N0110)
FRAME (12V109) 10 VERTICAL DEADEND
INSTL 3/8" PRl DIG TO NEW 12" AHR, L=10' E (GO113, A0102)
XFR 25 KVA OH XFMRA(12V601)
UTC # __ b3Z�
�DP45--------
SER#----------
XFR OH SVCS
RMV EXIST SEC UG RISER
INSTL 3" SEC RISER (FO106)
RUN 50' OF 350 KCMIL TPX TO PED (C1204)
STRIP AND TeP PE)
E FOR CE)M\1UNI T1/1NS
- PUD TO ENFORCE POLE ATTACHMENT
AGREEMENT.
- PUD IS RESPONSIBLE FOR ENSURING THAT THE
OLD POLES ARE REMOVED. 25
1 � ------------------
T O W S G 1VAL*9 Cv /0�Rz i- i1,te'417-
12-404
NTS
OWNER/CONTRACTOR IS RESPONSIBLE FOR
1 EROSION CONTROL AND DRAINAGE
0 1 2 3 4 5 6 7 8 9 10 11 12 1 14 15 6
1'205 14 20 %926 932-CCa
SL-131640-H
SJ 15-9751
947
FU15
N
rn 17
cl-
SL-131647-H 9
ENGINEERING DIVISION `j
APPROVED AS NOTED
JX iAlQ.iJu. wz 11/29/2023
VV
25-1D32� MAPLE VVY
955 Op
---------------- 294610
915 0;
g23
15-9 92
LAYOUT
1" = 50'
205 4 45
,933 935
S -�129783-A
3 50-3517 0
OWNER/CONTRACTOR RESPONSIBLE FOR LOCATING
ALL ON SITE UTILITIES. RELOCATION/REVISION TO ANY
UTILITIES MAY REQUIRE A SEPERATE PERMIT.
RECEIVED
CITY OF EDMONDS
Project Name: Original WO has been closed' lease use 100106479. DEVELOPMENRVICES
g � p DEPART
MMENENT
Scope of Work: Distribution pole was BO. PUD crews replaced the pole with a similarly sized one (45-foot
class 2), and rebuilt a 3" secondary riser on the new pole.
The crew also replaced the primary and neutral copper conductors between the newly installed pole and
the pole to the west with #2 ACSR wire.
PUD crew topped old pole and left it for Ziply to remove once they transfer their equipment to the new
pole.
No cuts in asphalt were made.
Location: Pole is located at 923 Maple Way, Edmonds. (pli 294610)
Which lane direction is being closed: (Job has already been worked) Crews would have had to occupy
the entirety of Maple Way. Maple way is single -lane, and more akin to a driveway than a residential road
Hours and Duration at the Location: All work was completed on 8/16/2023, in approximately 6 hours.
Traffic control plan: This job has already been worked, so no traffic control plan is included.
RECEIVED
Nov 13 2023
--- CITY OF EDMONDS ,
MyBuildingPermit.com
DEVELOPMENT SERVICES CITY OF EDMONDS
DEPARTMENT
Right -of -Way Application #1403377-100106479 (After action req 923 Maple St, Edm(
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
923 MAPLE ST
City Zip Code County Parcel Number
EDMONDS 98020 00434206903200
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
Jordan D & Barbara T Kostelyk
Number Street Apartment or Suite Number
923 MAPLE ST
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: 11/13/2023 Submitted By: Moe Matthews
Page 1 of 2
CITY OF EDMONDS MyBuildingPermit.com
Right -of -Way Application #1403377-100106479 (After action req 923 Maple St, Edmi
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 Disturbance of Surface
Project 100106479 (After action req 923 Maple St, Edmonds)
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 100092667 is closed so we are using work order
100106479 to apply for this permit. Distribution pole, PLI 955 was BO. PUD crews replaced the
Description pole with a similarly sized one (45-food class 2) and rebuilt a 3" secondary riser on the new pole.
of Work: The crew also replaced the primary and neutral copper conductors between the newly installed
pole and the pole to the west with #2 ACSR wire. PUD crew topped the old pole and left it for
Ziply to remove once they transfer their equipment to the new pole. No cuts in asphalt were
made. Pole is located at 923 Maple St, Edmonds. Crews would have had to occupy the entirety
of Maple Way. All work was completed on 8/16/23 in approximately 6 hours.
Project Details
Project Information
Job Number
100106479
Page 2 of 2