APPROVED ENG2024-0261 ROW PERMITRIGHT OF WAY EUC PERMIT
PERMIT NUMBER
City of • • .
Sth Ave N, Edmonds WA :� 1 1
www.edmondswa.gov LA
Description: ZIPLY - TRANSFER LINES AND REMOVE 2 BO POLES NJUNS 6015938
ISSUED: 07/15/2024
Address: 6615 172ND ST SW EDMONDS WA 98026-5220
EXPIRES: 01/15/2025
Permit Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 00478300000100
NAME TYPE NAME ADDRESS PHONE
APPLICANT ARIANNE MOMMSEN 426 E CASINO ROAD, EVERETT WA 98208 (425)375-0838
CONTACT ZIPLY FIBER NORTHWEST LLC 426 E CASINO ROAD, EVERETT WA 98208 (425)375-0838
CONTRACTOR ZIPLY FIBER 1800 41ST ST, EVERETT WA 98201 (425)949-0230
OWNER KATE & SUTHERLAND JOH BRADBURY 21227 58TH AVE W 3, MOUNTLAKE TERRACE WA 98043
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE - PER PERMIT
$45.00 $45.00
ENG - INSPECTIONS - 4.1.24
$132.00 $132.00
ROW - STANDARD - 4.1.24 $396.00 $396.00
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: 07/15/2024
Printed: Monday, July 15, 2024 4:48:46 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
X-2 ENGINEERING FINAL**
Printed: Monday, July 15, 2024 4:48:46 PM 2 of 2
RECEIVED
Lti�y of ED%�O�
ANC. 1 g90
SECTION A
RIGHT OF WAY CONSTRUCTION
PERMIT APPLICATION
Complete and submit this Application in accordance with the Submittal
Requirements outlined in Right -of -Way permit Handout E63.
May 28 2024
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 Info
Project Name W09344721
Site Address or if no site address use Property Address at NW corner of project area: 6615 172nd PI SW, Edmonds, WA 98026
Associated Permits: BLD PLN ENG
Owner and Entity Holding Franchise (if applicable)
Name of Company Ziply Fiber Northwest, LLC Franchise Ordinance No: WN U-17
PointofContact Mike Hakahan
Title Engineer
Address426 E Casino Rd
city Everett
State WA
zip 98208
Phone 425-949-0230
Email mike.hakahan@ziply.com
AuthorizedContractor and Agent •below)
NameofCompany Ziply Fiber Northwest, LLC
Primary Name Mike Hakahan
Agent Name Mike Hakahan
Title Engineer
Title Engineer
Mobile 425-949-0230
Address426 E Casino Rd.
Email mike.hakahan@ziply.com
city Everett
I State WA
zip 98208
Secondary Name
Phone 425-949-0230
Title
Email mike.hakahan@ziply.com
Mobile
City of Edmonds Business License No: 3 1 3-0 1 3-420
Email
State License No: ZIPLYFN782L3
0 Contractor verifies it is currently bonded
Contractor verifies it currently has general liability insurance
NOTE: ECDC 18.6o.02o 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 well)
❑ Traffic Control Only (no associated development)
City of Edmonds ROW construction permit Application --Page 1 of 3 Updated 3/25/2021
❑ Utility Franchise Work (no associated development)
Project Description
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.)
Telecommunications and broadband provider Ziply Fiber to
ACCESS POLE AND TRANSFER ATTACHMENTS AND REMOVE OLD POLE
RIGHT-OF-WAY
CLOSURE
AREA
TOTAL
DURATION
(Number of Months)
Sidewalk 72 hours +
LF
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LF
SF
Alley 72 hours +
LF
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SF
Parking 72 hours +
LF
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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 ❑ power ❑ gas
❑ water ❑ sewer ❑ storm
1.
CompletedDetails of Work to be
Does the utility owner have existin overhead infrastructure in the area of work?
•
2.
Will any equipment be added underground or above ground (e.g. pedestals, vaults, etc.)?
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?
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 system?
5.
Does the work involve proposed additions to an aboveground utility system? If es:
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 • to be Completed
®i
6. Does your project involve rebuilding or replacing utility equipment which currently serves more
✓
than one lot or commercial development?
City of Edmonds ROW construction permit Application --Page 2 of 3 Updated 3/25/2021
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:
How many are existing? 12 1 How many are to be added?
6b.
Does your project involve poles? If yes:
How many poles are existing in the project area?
2
What is the height of the existing poles?
How many poles are to be removed?
2
Are additional poles to be laced?
2
How many? I I What is the height of the additionalpoles?
6c.
Are any poles to be modified/rebuilt/replaced? If yes:
How many? I I What is the height of the poles after?
Describe the modification rebuild:
Ai
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: Amb&r L tAl DATE: 5/27/2024
APPLICANT PRINTED NAME: Amber Luna
APPLICANT TITLE:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021
LEGEND:
SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM
EXISTING UTILITY POLE
® PROPOSED NEW POLE
WORK DETAILS:
ACCESS POLE AND TRANSFER ATTACHMENTS
AND REMOVE OLD POLE
N RECEIVED
Know wnat°� below
Call before you dig. May 28 2024
CITY OF EDMONDS
DEVELOPMENT SERVICES
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07/11 /2024
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APPROVAL MUST RESULT FROM THE TRAFFIC ENGINEER OR OTHER PUBLIC OFFICIAL HAVING STATUTORY
ENFORCEMENT AUTHORITY IN THE JURISDICTION. UTILIZATION AND IMPLEMENTATION OF THIS PLAN
SHALL BE A RESULT OF THE APPROVAL. REF. MUTCD 2009 6A - 01 (10)
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SIGN SPACING = X (1)
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800' ±
RURAL ROADS 45 / 55 MPH
500' ±
RURAL ROADS & URBAN ARTERIALS 35 / 40 MPH
350' ±
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RESIDENTIAL & BUSINESS DISTRICTS
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(1) ALL SPACING MAY BE ADJUSTED TO ACCOMMODATE INTERCHANGE RAMPS,
AT -GRADE INTERSECTIONS AND DRIVEWAYS
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APPROVAL MUST RESULT FROM THE TRAFFIC ENGINEER OR OTHER PUBLIC OFFICIAL HAVING STATUTORY
ENFORCEMENT AUTHORITY IN THE JURISDICTION. UTILIZATION AND IMPLEMENTATION OF THIS PLAN
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SCALE:
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NO: 1 OF 3
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/// May 28 2024 /
CITY OF EDMONDS CITY OF EDMONDS MyBuildingPermit.com
DEVELOPMENT SERVICES
DEPARTMENT
Right -of -Way Application #1494568 - W0934721
Applicant
First Name Last Name Company Name
ARIANNE MOMMSEN Ziply Fiber Northwest LLC
Number Street Apartment or Suite Number E-mail Address
426 E Casino Road Permits@atcotelecom.com
City State Zip Phone Number Extension
Everett WA 98208 (425) 375-0838
Contractor
Company Name
ZIPLY FIBER
Number Street Apartment or Suite Number
135 Lake St S Ste 155
City State Zip Phone Number Extension
KIRKLAND WA 98033 (425) 284-8155 (425) 263-4020
State License Number License Expiration Date UBI # E-mail Address
ZI PLYF*800L5 6/2/2024 FD4477g7D caitlin.reid@ziply.com
Project Location
Number Street Floor Number Suite or Room Number
6615 172ND ST SW
City Zip Code County Parcel Number
EDMONDS 98026 00478300000100
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
Kate & Sutherland John Bradbury
Number Street Apartment or Suite Number
21227 58TH AVE W 3
City State Zip
MOU NTLAKE WA 98043
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: 5/27/2024 Submitted By: ARIANNE MOMMSEN
Page 1 of 2
i
CITY OF EDMONDS MyBuildingPermit.com
Right -of -Way Application #1494568 - W0934721
Project Contact
Company Name: Ziply Fiber Northwest LLC
Name: ARIANNE MOMMSEN Email: Permits@atcotelecom.com
Address: 426 E Casino Road Phone #: (425) 375-0838
Everett WA 98208
Project Type
Utility Purveyor
Activity Type
Utility Work
Scope of Work
Disturbance of Surface
Project Name: W0934721
Description of Work: ACCESS POLE AND TRANSFER ATTACHMENTS AND REMOVE OLD POLE
Project Details
Project Information
Job Number
W0934721
Page 2 of 2