APPROVED ENG2024-0121 ROW PERMITRIGHT OF WAY EUC PERMIT
PERMIT NUMBER
City of • • .
98020 ENG2024-0121
www.edmondswa.gov i
Description: PUD - EMERGENCY REPAIR TO CELL ANTENNA ISSUED: 04/02/2024
Address: 8317 188TH ST SW EDMONDS WA 98026-6025
EXPIRES: 10/02/2024
Permit Type: RIGHT OF WAY EUC Permit Subtype: MINOR Parcel Number: 00567500002300
I 11-14111 a
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)319-4209
CONTRACTOR SNOHOMISH COUNTY PUD PO BOX 1107, EVERETT WA 98206 (425)783-4353
OWNER ROMBAKH REAL ESTATE LLC 688 110TH AVE NE, BELLEVUE WA 98004
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE - PER PERMIT
$45.00 $45.00
ENG - INSPECTIONS
$252.00 $252.00
RIGHT-OF-WAY PERMIT -MINOR $126.00 $126.00
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: 04/02/2024
Printed: Tuesday, April 02, 2024 1:00:54 PM 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
E-7 TRAFFIC CTRL
X-2 ENGINEERING FINAL**
Printed: Tuesday, April 02, 2024 1:00:54 PM 2 of 2
WO# 100129464
of EpM04O�
SECTION A
RECEIVED
RIGHT OF WAY CONSTRUCTION MAR 25 2024
PERMIT APPLICATION
Complete and submit this Application in accordance with the Submittal CITY OF EDMONDS
Requirements outlined in Right-of-Wgy permit Handout E6�. 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 T-MOBILE PERRINVILLE - SE01553 -REPAIR "EMERGENCY"
Site Address or if no site address use Property Address at NW corner of project area: 8317 188th St SW Edmonds, WA
Associated Permits: BLD PLN ENG
Owner and Entity Holding Franchise (if applicable)
Name of Company Snohomish County PUD NO.1 Franchise Ordinance No: NSA
Point of Contact Aziz Haq
Title Engineer
Address P.O. Box 1107
City Everett
State WA
Zip 98206
Phone 425-783-5251
Email permits@snopud.com / MahaQ@snopud.com
Contractor and Authorized Agent of Owner
Name of Company same info as above
(see note below)
Contractor Contacts During Construction
Primary Name same info as above
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
U Contractor verifies it is currently bonded
® 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 ❑ 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
R 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.)
This work includes repairing the existing T-Mobile antenna site located on the steel transmission pole near the listed address.
The antenna mounting has come loose and antenna is pointing down towards the ground. This needs to be corrected as soon as possible.
large equipment required to access the pole top. Refer to ENG2021-007 for similar road closure request for same pole location.
In order to access pole top the road will need to be closed to correctly position equipment to reach pole top. Work should take between 6 to 8 hrs.
If weekend work is preferred to minimize impact, work can be completed on the weekend.
RIGHT-OF-WAY
CLOSURE
AREA
TOTAL
DURATION
(Number of Months)
Sidewalk 72 hours +
LF
x
LF
SF
N/A
Alley 72 hours +
LF
x
LF
SF
Parking 72 hours +
LF
x
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 iR 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
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?
If yes, answer the following questions related to project area, i.e. the actual area in which the
project is proposed:
x
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:
APPLICANT PRINTED NAME:
APPLICANT TITLE:
Aziz HaQ
Engineer III
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
03/21 /24
City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021
SNOHOMISH COUNTY
IP WAl
PUBLIC UTILITY DISTRICT Na.1
T—MOBILE PERRINVILLE — SE01553E
CONSTRUCTION OPERATIONS AND ENGINEERING REQUEST
TO
FROM
DATE
KEITH ELLISON
AZIZ HAO 425-319-4209
3/21/24
ADDRESS/LOCATION/POLE NUMBER
8307 188TH ST SW, LYNNWOOD,
WA / 18(27-4)NE //
PL1:229080
MAP NO.
ORDER NO.
OPERATION NO.
454-J3
100129464
30
ACTION•
PLEASE ASSIST T-MOBILE WITH
THE REPAIR OF THEIR ANTENNA SITE RECEIVED
FIX THE LOOSE/BROKEN ANTENNA MOUNTING IN GAMMA SECTOR MAR 25 2024
POLE HEIGHT: 93' AGL
CITY OF EDMONDS
�v r�nnnnniT
21
OUTAGE WINDOW: SERVICES DEPARTMENT
SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM
115kV SCHEMATIC
PLAN VIEW
NTS
------------+
NTS
1 ,
I ,
1 ,
'
C
PERRINVILLE S 4179 S
Za MvA ; ;
'
17
24L25
1533 ;
1
2 4 18725
1-1
7
L-o 1
1 1 1 �,)0 MI 336.E KCM AA
WORK SITE -128196-A
373
J
FU1
229080 7
�.✓ 1633 n
I li-E-L
1.01 MI 336.E KCM AA
If 1 1 336.4-
1
?
Mit
SW214
Q
u u
Q
c s Ta36 s m
o
f
1 ,
'
1
N
0
14 0
p
NORTH
MAPLEWOOD
�
o0
25 MVA
For de -energizing customer service
for Customer work
CUSTOMER CREW HOURS
When completed.
-783-1000or (1-877-783-10 0) osklor Energy Control
Customer Signoture
Dote
ACTIONOR
OTHER ACTIONREQUIRED
ENGINEERING DIVISION
Applicant shall repair/replace all
APPROVED AS NOTED
damage to utilities or frontage
improvements in City right-of-way
per city standards that is caused or
-1,11 tyl"Ju'4z 04/01/2024
Vill
occurs during the permitted project.
APPROVED BY
COMPLETED BY
DATE
Dispc
Distribution: White -Deportment Responsible For Work -Return To Originolor When CompleledConOyeD@Wt& ItAResp"bleC6iopidN6fW;h leOS9
SIGN SPACING
= X
FREEWAYS & EXPRESSWAYS
55/70 MPH
1500'±
RURAL HIGHWAYS
60 /65 MPH
800'1
RURAL ROADS
45 / 55 MPH
5001±
RURAL ROADS & URBAN ARTERIALS
35 /40 MPH
350'±
RURAL ROADS & URBAN ARTERIALS
RESIDENTAL & BUSINESS DISTRICTS
25 / 30 MPH
200'± (2)
URBAN STREETS
25 MPH OR LESS
100'± (2)
(1) ALL SPACING MAY BE ADJUSTED TO ACCOMMODATE INTERCHANGE
RAMPS., AT -GRADE INTERSECTIONS AND DRIVEWAYS.
(2) THIS SPACING MAY BE REDUCED IN URBAN AREAS TO FIT
ROADWAY CONDITIONS.
ROAD
+ t
CLOSED
AHEAD
W20.3
DETOUR
AHEAD
W20.2
24'' x 24"
PEED
SLIMIT
25
R3.2
f 88th St SIN
TABLE (1)
CHANNELIZATION DEVICE
SPACING (feet)
MPH TAPER TANGENT
50/70 40 80
35/45 30 60
25/30 20 40
ical Road Closvra wl Da+torr
O W/B 188th St SW closed between 83rd Ave W & 84th Ave W.
O Local access maintained for residents.
O Sidewalk on the south side of 188th St SW unaffected.
O Parking Lane not present.
o Transit route not present.
o REASON: To replace all antenna equipment on existing
Pole / CeII Site.
MANDATORK o Equipment needed to perform task shall take vp the entire
width of roadway.
CLOSURE AFFECTS RESIDENTS
48' x 60"
ROAD
WILL BE
CLOSED
c/dnc TO KIDUM
K AM TO K PM
RS S.1501
INST! LL If D/YS
PRIOR TO CLOSURE
48"x 30"
24'' x 36"
LOCAL
ROAD
ACCESS
OHLN
CLOSED
_
r�' 3
SEE INSET BELOW
FOR
DETOUR ROUTE
DETh-ILS
TRAFFIC CONTROL PLAN
EDMONDS, WA
N
W E
S
NOT TO SCALE
DRIVEWAYS. SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM
PROPERTY OWNER PERMISSION ADVANCE WARNING SIGNS
REQUIRED TO BLOCK DRIVEWAYS. SPACED @ (K) OR AS PER
SITE CONDITIONS.
NOTIFY AFFECTED RESIDENTS OF
TRAFFIC CONTROL INSPECTION SHALL BE REFER TO SIGN SPACING CHART. WORK TIMES/DATES. RESIDENCE: RESIDENCE: REQUIRED WHENEVER WORK ZONE IS SET UP
8317188th St SW 8307188th St SW 60Vx48''
Edmonds, WA 98026 Edmonds, WA 98026 ROADPDLOSED DETOUR ROAD
THRUTRAFFIC CLOSED
Ri7.4
Cell Site AHEAD AHEAD
W20.2 W20.3
NO SIDEWILK THIS
SIDE OF STREET
--——————
—m———————————————————————
n
60" x 46" 24�" x 24''
ROAD DETOUR TO
AHEAD
ROAD CLOSED
CLOSED AHEAD THRUTRAFFIC 1♦
W20.3 W20.2 R7i�
R34
DETOUR
AHEAD
ADVANCE WARNING SIGNS
SPACED @ (K) OR AS PER ,� W20.2
SITE CONDITIONS.
REFER TO SIGN SPACING CHART. I ROAD
00 CLOSED
AHEAD W20.3
GENERAL NOTES:
1.
ALL SIGNS AND SPACING SHALL CONFORM TO THE MUTCD SPECS.
2
NOTIFY LOCAL RGENCY SERVICES OF CLOSURE TIMES AND
DATE (OPTIONAL).
RECEIVED
3.
SIGN SPACING MAY BE REDUCED IN URBAN AREAS TO FIT ROAD
CONDITIONS.
MAR 25 2024
4.
PROTECTIVE VEHICLE RECOMMENDED.MAV BE A WORK TRUCK.
5.
ALL SIGNS MIN. 48" K 48" UNLESS OTHERWISE SPECIFIED.
6.
CHANNELIZATION DEVICES ARE 28"' REFL. CONES (see TABLE (1)
CITY OF EDMONDS
for spacing distances).
DEVELOPMENT
7.
ALL SPACING MAN BE ADJUSTED TO ACCOMMODATE AT.GRADE
SERVICES DEPARTMENT
INTERSECTIONS AND/OR DRIVEWAYS.
❑❑❑F24" x 24''
R34
RESIDENCE: RESIDENCE:
8314188/th St SW 8302 188th St SW
Edmonds, WA 98026 Edmonds, WA 98026
INSET
onoua .a.m s�sw
y
O 0
3
a
aka
0
SIDEWILK MIINTIINED
THIS SIDE OF STREET
Go
ENGINEERING DIVISION
APPROVED AS NOTED
Jul W1,11. 44z 04/01 /2024
vv
I E:r_E kin
11-7-7-777-A WORK AREA
-1 ❑ E ❑ ❑ 28"' REFL. CONE
t-I SIGN LOCATION
/ 241' xx224"
R3.2
DETOUR
AHEAD
W20.2
ROAD
CLOSED
AHEAD
W2_0.3
PROTECTIVE/WORK VEHICLE
® POLE LOCATION
(Cell Site)
188th St SW
k "ASH1A'GTOL"' S: A*E TRAFFIC C017ROL
SUPERVISOR
ROAD
WORK
.h AP7E: Greg Siler AHEAD
rCS CARD # 012604
EXP. DATE 1013112024
Greg Si er
i ��
PUBLIC UTILITY DISTRICT NO. 1
RECEIVED
CITY OF EDMONDS
Right -of -Way Application #1461930 - WO 100129464
MAR 25 2024
MyBuildingPerrnit.com
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
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
8317 188TH ST SW
City Zip Code County Parcel Number
EDMONDS 98026 00567500002300
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
ROMBAKH REAL ESTATE LLC
Number Street Apartment or Suite Number
688 110TH AVE NE
City State Zip
BELLEVUE WA 98004
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: 3/21/2024 Submitted By: Moe Matthews
Page 1 of 2
i
CITY OF EDMONDS MyBuildingPermit.com
Right -of -Way Application #1461930 - WO 100129464
Project Contact
Company Name: Snohomish County PUD
Name: Aziz Haq Email: mahaq@snopud.com
Address: PO Box 1107 Phone #: (425) 319-4209
Everett WA 98206
Project Type Activity Type Scope of Work
Utility Purveyor Utility Work No Disturbance of Surface
Project WO 100129464
Name:
WO 100129464: Would it be possible to expedite review of this application for emergency
repair? PUD crews to repair existing T-Mobile antenna site located on steel transmission pole
near listed address. Antenna mounting has come loose and antenna is pointing down towards
Description ground. This needs to be corrected as soon as possible. Large equipment is required to access
of Work: the pole top. Please refer to ENG2021-0071 for similar road closure request for same pole
location. In order to access pole top, the road will need to be closed to correctly position
equipment to reach pole top. Work should take between 6-8 hours. If weekend work is preferred
to minimize impact, work can be completed on the weekend.
Project Details
Project Information
Job Number
WO 100129464
Page 2 of 2