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ENG2024-0049 ROW PERMITRIGHT OF WAY EUC PERMIT PERMIT NUMBER City of Edmonds A•:0004• www.edmondswa.gov i Description: PSE - RELOCATE STUB FOR CITY DRAINAGE PROJECT ISSUED: 03/04/2024 Address: 22130 92ND AVE W EDMONDS WA 98020-4502 EXPIRES: 09/04/2024 it Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 00391800000500 W NAME TYPE NAME ADDRESS PHONE APPLICANT SUSAN SIDICK 1660 PARK LANE, BURLINGTON WA 98233 (425)457-6353 CONTACT PUGET SOUND ENERGY 1660 PARK LANE, BURLINGTON WA 98233 (425)457-6353 CONTRACTOR PSE/INFRASOURCE 1660 PARK LANE, BURLINGTON WA 98233 (425)466-4771 OWNER AUGUST D BAS 22130 92ND AVE W, EDMONDS WA 98020 FEE INFORMATION DESCRIPTION AMOUNT PAID CITY TECHNOLOGY FEE - PER PERMIT $45.00 $45.00 ENG - INSPECTIONS $252.00 $252.00 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: 03/04/2024 Printed: Monday, March 04, 2024 11:52:23 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** E-7 RESTOR LIMITS Printed: Monday, March 04, 2024 11:52:23 AM 2 of 2 ofE°M°tio� RECEIVED RIGHT OF WAY CONSTRUCTION Feb 06 2024 PERMIT APPLICATION CITY OF EDMONDS DEVELOPMENT SERVICES Complete and submit this Application in accordance with the Submittal DEPARTMENT /'Vc. is') Requirements outlined in Right -of -Way permit Handout E6�. 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 892o69404 Site Address or if no site address use Property Address at NW corner of project area: 22130 92 Ave w Associated Permits: BLD PLN ENG X Owner and Entity Holding Franchise (if applicable) Name of Company PSE/Infrasource Franchise Ordinance No: Point of Contact Susan Sid ick Title SR Permit Specialist Address 1660 Park lane city Burlington State WA Zip 98233 Phone 425-457-6353 Email susan.sidickapse.com Contractor and Authorized Agent of Owner Name of Company (see note below) Contractor Contacts During Construction Primary Name PSE/Infrasource Susan Sidick Agent Name PSE/Infrasource Title SR Permit Specialist Title SR Permit Specialist Mobile 425-457-6353 Address 1660 Park lane Email susan.sidick@pse.com City Burlington State WA Zip 98233 Secondary Name Phone 425-457-6353 Title SR Permit Specialist Email susan.sidick@pse.com Mobile City of Edmonds Business License No: Email State License No: INFRASL871 C2 [N Contractor verifies it is currently bonded d( Contractor verifies it currently has general liability insurance NOTE: ECDC 18.6o. 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 ix 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.) Relocate stub and partial ext for City of Edmonds Drainage Improvement project. Work area is aprox 191-18o' S c/1 of 221st ST SW & 12'-40' W c/l of 92nd AVE W (2) 3x5 Blacktop/ soft surface and (1) 3x5 soft surface cuts anticipated PLEASE RUSH CITY DRAINAGE PROJECT 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 1 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 3xgas ❑ water ❑ sewer ❑ storm Details of Work to be Completed 1. Does the utility owner have existing overhead infrastructure in the area of work? Yes No x 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? x Are the additions for the purpose of serving a single-family residential subdivision? x 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? x If yes, answer the following questions related to project area, i.e. the actual area in which the project is proposed: 6a. Does your project involve wires/cables/lines? If yes: x How many are existing? I I How many are to be added? 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? What is the height of the existing poles? How many poles are to be removed? Are additional poles to be laced? 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? I I What is the height of the poles after? Describe the modification rebuild: 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: Susan Sidick DATE: 02/o6/24 APPLICANT PRINTED NAME: Susan Sidick APPLICANT TITLE: SR Permit Specialist 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 Job #: 892069404 PRE -INSPECTION REPORT ® PUG t ; _�JUND ENERGY Date: Jurisdiction: Right of Way Permit? Est. Start Date: Est. Duration: 1/19/24 Edmonds ❑✓ YES ❑ NO End of March 1 day Address: City / Zip: Customer: PM / Insp: 22130 92nd Ave W Edmonds City of Edmonds: Ryan Hague / Haly Rylko 360-618-1014 Eric Liaw 425-495 3297 PHONE NUMBER WORK DESCRIPTION: Relocate 1-1/8" PE scat stub and partial ext for City of Edmonds Construction Method New Construct ❑ Drainage Improv. Relocate stub to 5 edge of driveway, T&T ext @ 40' W. No depth requirement. 60' R/W. Install 2600 EFV. RESTORATION LIMITS TO BE DETERMINED Existing Open Trench BY CITY ENGINEERING INSPE(,�� Trenchless ❑ PLAT MAP: p/L — NOT TO SCALE RECEIVED I Y A' 1`I Install new 1-1/8"PE stub ! — I Feb 06 2024 along S edge of driveway, T&T 00 ! > @ 40' W CITY OF EDMONDS I a DEVELOPMENT SERVICES GJ DEPARTMENT W I I I 92nd Ave W ! I 60' R/W I al ! al ! NI I I I Driveway I I I i 22130 ................ ............... .................... . 180'S 1-1/8" PE SVC ®--------- —��.� f 1911S 40' W ! I Proposed OWNER/CONTRACTOR RESPONSIBLE FOR LOCATING Rain Garden ALL ON SITE UTILITIES. RELOCATION/REVISION TO ANY UTILITIES MAY REQUIRE A SEPERATE PERMIT. i ......... ......... ...........-.-.....: I I Applicant shall repair/replace all ENGINEERING DIVISION I damage to utilities or frontage improvements in City right-of-way APPROVED AS NOTED P/L per city standards that is caused or OWNER/CONTRACTOR IS RESPONSIBLE FOR occurs during the permitted project. Jill 03/01/2024 VV EROSION CONTROL AND DRAINAGE Work Location Size of Cut Surface Type 191 ' S f CL 221st St SW & 12' f CL 92nd Ave W 3x5 Soft/BT 180' S f CL 221st St SW & 12' f CL 92nd Ave W 3x5 Soft/BT 191' ' S f CL 221st St SW & 4_0 W of CL 92nd Ave W 3x5 Soft ❑✓ FLAGGERS # MPH ❑ TROLLY LINES ❑ BUS STOP # ❑ METER HOODS # ❑ OFFICERS # SPEED LIMIT ❑ TRAFFIC SIGNAL ❑ ARTERIAL ❑ NO PARKS # ❑ Commercial ❑ Altered Commercial ❑ Manifold Service Information ❑ Template Bar ❑✓ Residential Q PI Relocate ❑ Main Extension Diameter Meter EFV Pressure ❑ Bollards # ❑ Multi-Familyp ❑ ❑ 5/8" ❑ Replacement Service Pothole ❑ 250 ❑ 775 ❑ 6"wc ❑ New Constr. ❑ Main Maintenance ❑ Bollards ❑✓ 1-1/8" ❑ 425 ❑ 1800 ❑ 2# 4"2. ❑Bollards 4" # ❑� Stub ❑ Service Maintenance ❑ 1-1/4" ❑ 630 ❑✓ 2600 ❑ 2 5# ❑ FUEL LINE PERMIT NEED ❑ Extension ❑ Valve Maintenance ❑ 2" ❑ 1000 ❑ 10,000 Fuel Line Length: ❑ Complete Sery ❑ Cut & Cap Mtr Loc: 03 ❑ 4" ❑ IMO ❑ NA Fuel Line Diameter: TEMPORARY TRAFFIC CONTROL PLAN 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 10' 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 191' SCL of 221st St SW & 12' WCL of 92nd Ave W, 180' SCL of 221st St SW & 12' WCL of 92nd Ave W and 191' SCL of 221st St SW & 40' WCL of 92nd Ave W. 9. If used, place NO -PARK signs 72 hours in advance of the day that the work is to be done. o AaV3Hd dorn oval OV3HV NJ O OV08 3NV13N0 Q 0 #22130 oIN2�OCI OV02i � � ON3 ni 0 o END ROAD WORK o � Zzt Q z b-£M W20-7A W20-1 K a ��a 1001> 1100'? -- N_ 221ST ST SW NO PARKING SIGN MUST BE PLACED 72 HOURS IN ADVANCE OF SCHEDULED WORK DATE r 0<= a �o RESIDENT(S) WILL BE INFORMED OF TEMPORARY DRIVEWAY CLOSURE D SIGN SPACING MPH "x" 60/65 1000, 45/55 500, 35/40 350' 30 200' 25 100' RECEIVED Feb 06 2024 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT ENGINEERING DIVISION APPROVED AS NOTED l W 1&41r ,44z 03/01 /2024 VV CHANNELIZATION DEVICE SPACING MPH TAPER TANGENT 55/70 40 80 35/45 30 60 25/30 20 40 LEGEND ® WORK PIT ® 28" TRAFFIC CONE TRAFFIC FLOW WORK VEHICLE/ FLASHING LIGHTS SIGN LOCATION RIGHT OF WAY Row FLAGGER Puget Sound Energy REV Designer: Traffic Control Supervisor : PUGET 9 F'a R. Nunes 01 /30/2024 1 SOUND Flaviana Nunes Card"°.,11/20 naEa-d avesnuires@Pse.eom Job # ENERGY 425-424-7386 (425)424-7388 Project Address: flaviana.rodriguesnunes@pse.com 11975583 22130 92nd Ave W, Edmonds Page 1 OF 1 RECEIVED M BuildingPermit.com Feb 06 2024 CITY OF EDMONDS CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT Right -of -Way Application #1438387 - 892069404 Applicant First Name Last Name Company Name Susan Sidick Puget Sound Energy Number Street Apartment or Suite Number E-mail Address 1660 Park Lane susan.sidick@pse.com City State Zip Phone Number Extension Burlington WA 98233 (425) 457-6353 Contractor Company Name PUGET SOUND ENERGY INC Number Street Apartment or Suite Number 1660 park lane City State Zip Phone Number Extension burlington WA 98233 (425) 457-6353 State License Number License Expiration Date UBI # E-mail Address PUGETSE032J 1 3/20/2024 179n 1 M55 susan.sidick@pse.com Project Location Number Street Floor Number Suite or Room Number 22130 92ND AVE W City Zip Code County Parcel Number EDMONDS 98020 00391800000500 Associated Building Permit Number Tenant Name 892069404 Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name August D Bas Number Street Apartment or Suite Number 22130 92ND AVE W 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: 2/6/2024 Submitted By: Susan Sidick Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Right -of -Way Application #1438387 - 892069404 Project Contact Company Name: Puget Sound Energy Name: Susan Sidick Email: susan.sidick@pse.com Address: 1660 Park Lane Phone #: (425) 457-6353 Burlington WA 98233 Project Type Activity Type Scope of Work Utility Purveyor Utility Work Disturbance of Surface Project Name: 892069404 Description of Relocate stub and partial ext for City of Edmonds Drainage Improvement project. Work area Work: is aprox 191-180' S c/I of 221st ST SW & 12'-40' W c/I of 92nd AVE W (2) 3x5 Blacktop/ soft surface and (1) 3x5 soft surface cuts anticipated Project Details Project Information Job Number 892069404 Page 2 of 2