ROW PERMIT ENG2020-0072RIGHT OF WAY EUC PERMIT
� City of Edmonds PERMIT NUMBER
. .
-0072
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Description: PSE-NEW WATER SERVICE CROSSING ISSUED: 02/24/2020
Address: 420 DAYTON ST EDMONDS WA 98020-3518
EXPIRES: 08/24/2020
Permit Type: RIGHT OF WAY EUC Permit Subtype: MINOR Parcel Number: 27032300407800
CONTACTS
NAME TYPE NAME ADDRESS PHONE
APPLICANT PSE/INFRASOURCE 1660 PARK LANE, BURLINGTON WA98233 (425)457-6353
CONTRACTOR PSE/INFRASOURCE 1660 PARK LANE, BURLINGTON WA 98233 (425)457-6353
OWNER PAYNE R GREGORY 8837 29TH NW, SEATTLE WA 98117
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE CHARGED PER PERMIT
$40.00 $0.00
ENGINEERING INSPECTION FEE
$220.00 $0.00
RIGHT OF WAY MINOR - EUC PERMIT FEE
$110.00 $0.00
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
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
THIS DOCUMENT IS NOT VALID UNTIL FEES ARE PAID AND THE CITY ENGINEER OR HIS/HER DEPUTY HAS SIGNED BELOW
DATE
Printed: Monday, February 24, 2020 8:48:33 AM 1 of 2
RIGHT OF WAY EUC PERMIT
PERMIT NUMBER
City of Edmonds
Edmonds :1 1 ENG2020-0072
-26
AIL jL1 'A
CONDITIONS
CONDITION TYPE
NOTES
ADJACENT PROPERTY
Easement and/or permission from adjacent property owner is required prior to entry or work within
an adjacent property.
Contractor/Owner shall be responsible for repair/replacement of all damage to utilities and/or
DAMAGE TO FRONTAGE
frontage improvements in city right of way per city standards that is caused by or occurs during the
IMPROVEMENTS
permitted project.
Alert affected residents and/or businesses prior to work start.
Verify clear bore crossings.
ENGINEERING OTHER
Restore landscape to like or better conditions.
Call for required inspections as noted.
ESC REQUIRED
Maintain erosion & sediment control per city standards.
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
HOLD HARMLESS
any and all claims for damages of whatever nature, arising directly or indirectly from the issuance of
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.
Sound/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 OR NOISE
weekdays and 10:00am to 6:00pm on Saturdays, excluding Sundays and Federal Holidays. At all other
times the noise originating from construction sites/activities must comply with the noise limits of
Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120.
UNDERGROUND UTILITY
Call for locates of underground utilities prior to any excavation.
LOCATES
INSPECTIONS
INSPECTION TYPE
DATE RESULT NOTES
COMPLETE
ROW TRAFFIC CTRL
E-6 ENGINEERING FINAL
E-7 CONCRETE SIDEWALK
Printed: Monday, February 24, 2020 8:48:33 AM 2 of 2
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ROW PERMIT NO.: ENG�l,0_6aq•Z
ENG�N� ISSUE DATE: a,h —o
RIGHT-OF-WAY CONSTRUCTION
!Nc' I S90 PERMIT APPLICATION
PROJECT NAME: 887033545
CONTRACTOR: PSE/Infrasource
Mailing Address: 1660 Park Lane, Burlington, WA 98233
State License #: INFRASL871 C2
City Business License #: NR-019840
CONTACT:
Susan Sidick
Phone #: 425-457-6353
Fax #:
Email4: susan.sidick@pse.com
—aLiability Insurance---M Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: c�
,i�ayton Ave
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
Commercial ❑ Subdivision ❑ City Project ❑ Traffic Control (Only)
❑ Multi -Family ❑ Single Family
❑ EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit?
ANY ASSOCIATED PERMITS?
❑ Other
❑ Yes ❑*_ No
BLD#
ENG# _
DESCRIPTION OF PROPOSED WORK (Be Specific) :
Break out new concrete sidewalk panel and expose new water service crossing at above x/y
location. verityifili5fted and it possible try to wrap and sip new insulating mucket between the
gas and water. Under job # 887033545
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES D NO Year:
PAVEMENT CUT: ❑ Yes ❑ No If yes, indicate size of cut: _x _—
CONCRETE CUT: EXYes ❑ No If yes, indicate size of cut: _ z__
RIGHT-OF-WAY
AREA
CLOSURE
TOTAL
DURATION
(NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF
X
LF
LF
SF
Alley 72 Hrs + LF
X
X
SF
Parking 72 Hrs + LF
LF
SF
APPLICANT TO READ AND SIGN
*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 is to 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.
Indemnity: The Applicant has signed an application which states he/she hold 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 defense -costs and attorney fees by reason
of granting this permit.
I have read the above statements and understand the permit requirements and acknowledge that I must
follow all requirements in order for the permit to be valid.
Ci icnn Cirlirlr
SIGNATURE
DATE 02/20/2020
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 012238
Card Exp. 09/30/2023
gregory.harwood@pse.com
OWNERICONTRACTOR IS RESPONSIBLE
FOR EROSION CONTROL AND DRAINAGE
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Applicant shall repair/replace all damage to
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utilities or frontage improvements in City
right-of-way per city standards that is caused
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or occurs during the permitted project.
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Notes:
1. All signs and spacing to conform to the MUTCD
and City of Edmonds standards.
2. All sidewalks, driveways, exits and egresses
shall be completely clear unless otherwise indicated.
3. Channelizing devices are 28" traffic cones.
Use traffic drums (barrels) with steady burning
Type C lights on all State Routes and Hwys.
4. Sign size can be a minimum of 36" x 36" and shall
not obstruct pedestrian access.
5. Crew is required to leave a minimum of 11' for
traveling lane width.
6. Alert affected residents and businesses.
7. Work to take place between 9 a.m. and 4 p.m
unless otherwise specified. All work for arterials
and major roadways will be from 9 a.m. to 3 p.m
8. Work area will be Work area will be 19' NCL of Dayton
St & 143' WCL of 5th Ave S.
9. If used, place NO -PARK signs 72 hours in
advance of the day that the work is to be done.
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TEMPORARY TRAFFIC CONTROL PLAN
ENGINEERING DIVISION
ROV D AS NOTED
D2rte - & 'v&
MOVE BUS STOP 400' WEST.
I COMMUNITY TRANSIT WILL BE
CONTACTED AT 425-353-7433
I 1 FIVE DAYS IN ADVANCE OF
SCHEDULED DATE.
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maintain (2)11' lanes min.
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PUGET
SOUND
ENERGY
JOB# 887033545
416 DAYTON ST, EDMONDS, WA 98020
2/19/2020
jason.bisenius@pse.com
425-424-7316
SHEET 1 of 1
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CHANNELIZATION
DEVICE SPACING
MPH
TAPER
TANGENT
55/70
40
80
35/45
30
60
25/30
20
40
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6-0ZM
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1
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----- 100'___ 100' 100,
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DAYTON ST
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ROAD
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WORK o
N
AHEAD
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SIGN SPACING
MPH
"x"
60/65
1000,
45/55
500'
35/40
350'
30
200'
25
100,
LEGEND
(�]
28" TRAFFIC CONE
WORK PIT
TRAFFIC FLOW
WORK VEHICLE/
FLASHING LIGHTS
SIGN LOCATION
RIGHT OF WAY
ROW
Job #:
Date:
Jurisdiction
Right of Way
887033545 PRE -INSPECTION REPORT
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Permit-. D YES ❑ NO
Est. Start Date:
Est. Duration:
Address:
City / Zip:
Q PUGErSOUND MEW Y
Customer:
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7ri ��,�vtl .rd�vr�� zOG. y37. 9 i �6
PHONE NUMBER
WORK DESCRIPTION; zn S. a!G Ltl� K .
Construction Method
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Et fos�, wafer %er ViGC nct C 1ti$�yq a Ste+^ crOt'JiK
9 5.
Trenchless El
Open Trench ❑
ScPert/-< <o.,� fjc%+�r�en d�/ �`�s-
New Construct El
Existin �
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Work Location
Size of Cut
Surface Type
19 a of CL f»7 -JT &113 'Wof CL 5 4_s_ S .
3' x
Fr_
_ 'N S of CL & 'E W of CL
_ 'N S of CIL _ & 'E W of CL
ETFLAGGERS # MPH ❑ TROLLY LINES BUS STOP # AJp f pz�We METER HOODS #
❑ OFFICERS # SPEED LIMIT ❑ TRAFFIC SIGNAL ❑ARTERIAL^ G nS�i u NO PARKS #
❑ Commercial ❑ Altered Commercial ❑ Leak Repair Service Information El Template Bar
❑ Residential ❑ Altered Residential CP Work Diameter Meter EFV Pressure
El Bollards 2.5" #
El Multi -Family Elcement Service ❑ Pothole El5/8" El250 ❑ 1800 El6' WC
❑ Bollards 4" #
❑ New Constr. EiNain Maintenance ❑ Extension ❑ 11/8" ❑ 425 ❑ 2600 ❑ 2#
❑ Stub ❑ Service Maintenance ❑ 11/4" ❑ 630 ❑ 10,000 ❑ > 5# ❑ FUEL LINE PERMIT NEEDED
❑ Extension ❑ Valve Maintenance ❑ 2" ❑ 1000 Fuel Line Length:
❑ Compete Sery ❑ Cut & Cap Mtr Loc• Fuel Line Diameter:
PERMIT REQUEST FORM
Date of Request: 02/18/20
Job number:
Job address
Project mgr:
PM email:
887033545
416 Dayton Ave
Betty Frank
betty.frank@pse.com
Estimated job start date:
Estimated job completion date:
03/30/20
03/30/20
City: Edmonds Zip:
PM contact #: (206) 716-2641
Description of work to be performed:
Rreak niit new concrete sidewalk panel and expose new water service crossing at above
x/y location. verify if shorted and if possible try to wrap and slip new insulating mucket
between the gas and water.
Pavement cut? ❑✓ Yes [—]No
If yes, Dimensions of Cut: Length 3' Width 5'
How many cuts? 1
Surface Type hard asphalt
Require trenching? [V]Yes ❑No
If yes, Dimensions of trench: Length N/A Width N/A Depth N/A
Method of installation:
Traffic impact:
Road closed ❑Yes
❑ No
Lane closed Eyes
❑ No How Many?
Shoulder closed Dyes
❑ No
Sidewalk closed ❑Yes
❑ No
Emergency Contact: thane suede
Cell Number: (206) 437-9170
Direction? West