APPROVED ENG2024-0103 ROW PERMITRIGHT OF WAY EUC PERMIT
PERMIT NU BE
City of Edmonds
- N, Edmonds WA 9:0ENG2024-01031
www.edmondswa.govi
Description: PUD - REPLACE 2 BO POLES WITH SIDEWALK RESTORATION
ISSUED: 07/16/2024
Address: 21612 78TH AVE W EDMONDS WA 98026-7930
EXPIRES: 01/16/2025
rmit Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 00512900000900
i
NAME TYPE NAME ADDRESS PHONE
APPLICANT MOE MATTHEWS PO BOX 1107, EVERETT WA 98206-1107 (425)783-5681
CONTACT SNOHOMISH COUNTY PUD 21014 63RD AVE W, LYNNWOOD WA 98036 (425)238-7372
CONTRACTOR SNOHOMISH COUNTY PUD PO BOX 1107, EVERETT WA 98206 (425)783-4353
OWNER BAXTER CHARLES W JR & ELAINE R 21612 78TH AVE W, EDMONDS WA 98026-7930
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE - PER PERMIT
$45.00 $45.00
ENG - INSPECTIONS
$504.00 $504.00
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: 07/16/2024
Printed: Tuesday, July 16, 2024 2:03:46 PM 1 of 2
RIGHT OF WAY EUC PERMIT
PERMIT NUMBE3
City of Edmonds
,...Ave
N, Edmonds WA 9:01 1 1
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**
E-7 CONCRETE SIDEWALK
E-7 RESTOR LIMITS
Printed: Tuesday, July 16, 2024 2:03:46 PM 2 of 2
RECEIVED
Uti�y of EDA1��V'
s
ANC. 1 S9�
SECTION A
RIGHT OF WAY CONSTII UCCTIOhl
PERMIT APPLICATION
Complete and submit this Application in accordance with the Submittal
Requirements outlined in Right -of -Way permit Handout E63.
MAR 11 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 •
Project Name REPLACE (2) BO DISTRIBUTION POLES PLI 14347, 14348
Site Address or if no site address use PropertyAddress at NW corner of project area: 21612 78TH AVE W, EDMONDS WA 98026
Associated Permits: BLD PLN ENG
Owner and Entity Holding
Name of CompauySNOHOMISH COUNTY PUD Franchise Ordinance No: N/A
Point of Contact KARL HAACK
Title ENGINEERING TECH II
Address 21014 63RD AVE W
CityLYNN WOOD State WA Zip 98036
Phone425-238-7372
Emai1KJHAACK@SNOPUD.COM & PERMITS@SNOPUD.COM
Contractor and Authorized Agent of Owner
Name of Company SAME AS ABOVE
(see note below)
Contractor Contacts During Construction
Primary Name SAME 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
o 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.
of Development — Check ALL that apply
❑ 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
e Traffic Control Only (no associated development)
e Utility Franchise Work (no associated development)
City of Edmonds ROW construction permit Application --Page 1 of 3 Updated 3/25/2021
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.)
REPLACE (2) EXISTING BAD ORDER 45' CL2 POLES WITH NEW 45' CL2 WOOD POLES. POLE PLI 14347 TO BE SET BEHIND SIDEWALK. 3 SEPARATE DAY PARTIAL
LANE CLOSURE OF WESTBOUND 216TH AT INTERSECTION OF 78TH AVE WAND 216TH ST SW BETWEEN THE HOURS OF 8:00AM AND 4:OOPM. 2 SEPARATE DAY
PARTIAL LANE CLOSURE OF SOUTHBOUND 78TH AVE W AT INTERSECTION OF 78TH AVE WAND 216TH ST SW BETWEEN THE HOURS OF 8:OOAM AND 4:OOPM. NO
TREE TRIMMING REQUIRED, NO PAVEMENT CUT, SOFT SURFACE WORK ON BOTH POLES. TRAFFIC CONTROL AND PEDESTRIAN DETOUR BY PUD.
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
N/A
Parking 72 hours +
LF
x
LF
SF
N/A
SECTION B - If you are not a utility company performing work in the City ROW, skip to SECTION C.
. The work in the right of way is on or for the following type of facilities::
❑ telecommunications ❑ cable s power ❑ gas
❑ water ❑ sewer ❑ storm
Details of Work to be Completed
1. 1 Does the utility owner have existing overhead infrastructure in the area of work?
Yes
YES
No
2. 1 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?
N O
4.
Does the work involve rebuilding or relocating an existing aboveground utility system which
connects a lot or commercial development to an existingunderground common utilitystem?
N O
5.
Does the work involve proposed additions to an aboveground utility system? If es:
NO
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 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:
NO
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.
I Does your project involve poles? If yes:
YES
How many poles are existing in the project area?
2
What is the height of the existing poles?
45'
How many poles are to be removed?
2
Are additional poles to be laced?
2
How many? 12 1 What is the height of the additional poles? 45'
6c.
Are any poles to be modified/rebuilt/replaced? If yes:
YES
How many? 12 1 What is the height of the poles after? 1 45'
Describe the modification rebuild: REPLACED
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:
3/11 /2024
APPLICANT PRINTED NAME: KART
APPLICANT TITLE: ENGINEERING TECH II
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
PUBLIC UTILITY DISTRICT NO.1 OF SNOHOMISH COUNTY CONSTRUCTION NOTES: RES U B
LOCATION 21612 78TH AVE W, EDMONDS WA 98026 LYNNWOODAREAOAT POLE PLI 14347:
POLE NO. PLI 14347, 14348 NE1/4S 30 T 27 R 4 DATE 3/4/24 ORDER 100128670 JUN 05 2024
REASON FOR WORK REPALCE (2) BO ENGINEER K HAACK OPERATION 0030 SET NEW 45' CL2 WOOD POLE 6.5' DEEP 6' NORTH AND 6' EAST W/GRNDS AS STAKED.
DISTRIBUTION POLES DRAFTER U.G. NO. SET POLE BEHIND SIDEWALK. FRAME POLE PER ASSY AS12F339 - 30 7' DOUBLE ALLEY ARM TANGENT. CITY OF EDMONDS
SCALE 1" = 100' DEVELOPMENT
APPROVED INSTALL 10 END OF ARM TAP AS12V115. SERVICES DEPARTMENT
& DATE PRINTED
DATE WORK COMPLETED
FOREMAN
FEES REQ'D ❑ YES ■ NO
PRIMARY OVERHEAD
❑ RESIDENTIAL
❑ COMMERCIAL
LEO NO.
'@9 '=$
SECONDARY OVERHEAD
BASIC FEE S
METER/CONV.POLE
PRIMARY UNDERGROUND
❑ RESIDENTIAL
❑ COMMERCIAL
BASIC FEE S
LEU NO.
'@9
=S
SECONDARY UNDERGROUND
BASIC FEE
S
@3
UNDERGROUND PLAT
BASIC FEE
5
FT.@S '=3
STREET LIGHTING
(� FTA$ '=S
WORK IN RIGHT OF WAY
❑ PRIMARY
❑ SECONDARY
FT@S '=3
MISCELLANEOUS FEES
VAULT
S
PERMIT
S
9
I TOTAL DUE S I
DATE PAID
RECEPT NO.
SERVICE ORDER NO.
LEGEND:
O EXISTING POLE
X EXISTING POLE -TO
• NEW POLE
NESC VIOLATIONS
■ NO ❑ YES (SEE NOTES)
PERMITS
(DATE GRANTED)
❑ TREE TRIM
❑ STATE
❑ COUNTY
■ CITY
EDMONDS
El
EASEMENTS
❑ REQUIRED
■ NOT REQUIREC
E-61741
DATE RELEASED
FOREIGN CONTACTS
■ JPN#
❑ JOINT TRENCH ZIPLY & CATV
❑ JOINT BORE ZIPLY & CATV
POLE STENCILING
FROM TO
TAKE OFF POLE
PRE—CONST. REQUIRMENTS
❑ TREE TRIM ❑ PUD LOCATOR
❑ BACKHOE ■ FLAGGING
■ ONE CALL DATE 3/11/24
No. 24086228/24086229
STREET LIGHTING
❑ YES ■ NO
M&R AS -BUILT
DATE INSTALL 3/8" DOWNGUY (G0113) AND 8" AHR (AO101) L = 5' N. TRANSFER SL-130107-A AND 8' AL SL ARM TO NEW POLE. FACE SOUTH.
SUBSTATION FIVE CORNERS
CIRCUIT NO. 12-1285 PHASE 321
ENGR'S TEL. #
425-670-3208
ENGR'S CELL #
425-238-7372
TRANSFER (3) OH EAST -WEST SPANS OF 336 AAC PRI AND NEUT TO NEW POLE
TRANSFER LATERAL SOUTH SPAN OF #2 ACSR PRI AND NEUT TO NEW POLE. FUSE FU 65 AMPS.
STRIP AND TOP OLD POLE TO COMMUNICATIONS.
TRANSFER OF UTILITIES, REMOVAL OF POLE AND FINAL RESTORATION TO BE CONSISTENT
WITH APPLICABLE POLE ATTACHMENT AGREEMENT(S)AND JOINT OWNERSHIP POLE AGREEMENT.
N ® AT POLE PLI 14348:
SET NEW 45'CL2 WOOD POLE 6.5 DEEP TIGHT SOUTH W/GRNDS AS STAKED.
FRAME POLE PER ASSY AS12V102 - 10 VERTICAL TANGENT (50-450).
INSTALL SINGLE PHASE XFMR MOUNTING ASSY AS12V601.
TRANSFER SL-130091-A AND 8' AL SL ARM TO NEW POLE. FACE EAST.
TRANSFER XFMR P-4061-X TO NEW POLE. TRANSFER D.G. AND AHR TO NEW POLE.
TRANSFER (4) OH SVCS TO NEW POLE. STRIP AND TOP POLE TO COMMUNICATIONS.
TRANSFER OF UTILITIES, REMOVAL OF POLE AND FINAL RESTORATION TO BE CONSISTENT
POLE SET 5' BEHIND SIDEWALK/CITY UTILITIESWITH APPLICABLE POLE ATTACHMENT AGREEMENTS) AND JOINT OWNERSHIP POLE AGREEMENT.
PLI 14349
SL-115375-A
PLI 14347
SL - 13010 7 - ANJOA
25-384635
PLI 14345
D--------------
W--------- ----V�
POLE SET 5'
BEHIND PAVEMENT/CITY
W 21601
Q P-4061 X
PLI 143 8
SL-130091-A
00
GIS —
GIS QC M&R / PLI 14404
GIS Ph JOINT USE 21623
LOCATION MAP PAGE 455-A7 21626 PLI 225910 0. 150-316062
A-4180
BE REMOVED
X NEW POLE TO REPLACE EXISTING
216TH ST S
21609 21604
POLE SHALL BE
- -
SETA MINIM M OF
5' FROM BA K OF
CURB 21615 21612
- I
I_
21601
OWNER/CONTRACTOR RESPONSIBLE FOR LOCATING
ALL ON SITE UTILITIES. RELOCATION/REVISION TO ANY LAYOUT
UTILITIES MAY REQUIRE A SEPERATE PERMIT.
POLE 1" = 100'
UTILITIES
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.
OWNER/CONTRACTOR IS RESPONSIBLE FOR
EROSION CONTROLAND DRAINAGE
OVHD 0
OVHD 0
PLI 14347
OVHD n
FU 65
AMPS
216TH ST SW 0
37.5 PLI 14348
KVA O
Ly
AMPSFU
PLI 14404
/ A-4180
6933 50 KVA
ENGINEERING DIVISION
APPROVED AS NOTED
Jill L0,, t$.,04Q 07/16/2024
VV SHEET j OF 1
SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM
LANE CLOSURE ON A TWO-LANE ROAD IN INTERSECTION GENERAL NOTES
(TWO FLAGGER OPERATION) 0 1. ALL SIGNS AND SPACING SHALL CONFORM TO THE MUTCD.
2. NOTIFY LOCAL EMERGENCY SERVICES OF CLOSURE TIMES AND
No TRAFFIC CONTROL INSPECTION SHALL BE �j _ 0 DATES (OPTIONAL).
o 1 REQUIRED WHENEVER WORK ZONE IS SET UP =�m
b 00 3. SIGN SPACING MAY BE REDUCED IN URBAN AREAS TO FIT ROAD
4mi
CONDITIONS.
zXfv 200'MIN 4. PROTECTIVE VEHICLE RECOMMENDED -MAY BE A WORK TRUCK.
X 300'MAX X NORTH 5. ALL SIGNS MINIMUM 48" X 48", UNLESS OTHERWISE SPECIFIED.
6. CHANNELIZATION DEVICES ARE 28" REFLECTIVE CONES. SEE TABLE 1
I� FOR SPACING DISTANCES.
O O 17, O �® 7 O O �� 7. ALL SPACING MAY BE ADJUSTED TO ACCOMODATE AT -GRADE
O
INTERSECTIONS AND/OR DRIVEWAYS.
0 0 0 0 0 0 0 0 0
-.0 SM HALL
IN.LANE MAINWIDTHI' 216 T H S T SW -►
TAPER
50' MIN
100' MAX
TABLE 1
0
CHANNELIZATION DEVICE
SPACING (FEET)
MPH
TAPER
TANGENT
50-65
10 TO 20
80
35-45
10 TO 20
60
25-30
10 TO 20
40
RECEIVED
MAR 11 2024
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
ENGINEERING DIVISION
APPROVED AS NOTED
,%l/ 07/16/2024
vv
TREET ENDS
W20-78
BE
PREPARED
TO STOP
OPTIONAL IF
40 MPH OR LESS
M
R 100' X
a.- O
o m
�o
x
o�
z N
G)
N
0
I
N
BUFFER DATA
LONGITUDINAL BUFFER SPACE = B
SPEED (MPH)
25
30
35
40
45
1 50
55
1 60
65
70
LENGTH (FEET)
155
200
250
305
360
1 425
495
1 570
645
730
TRANSPORTABLE ATTENUATOR ROLL AHEAD DISTANCE = R
HOST VEHICLE WEIGHT
9,900 TO 22,000 LBS.
HOST VEHICLE WEIGHT
> 22,000 LBS.
< 45 MPH
45-55 MPHI
> 55 MPH
< 45 MPH
45-55 MPHI
> 55 MPH
100' 1
123' 1
172'
74'
100' 1
150'
SIGN SPACING = X
FREEWAYS & EXPRESSWAYS
55-70 MPH
1500'±
RURAL HIGHWAYS
60-65 MPH
800'±
RURAL ROADS
45-55 MPH
500'±
RURAL ROADS & URBAN ARTERIALS
35-40 MPH
350'±
RURAL ROADS & URBAN ARTERIALS
RESIDENTIAL & 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.
THIS PLAN MAY BE MIRRORED FOR
OPPOSITE SIDE OF ROADWAY USING
SAME SIGNS AND SPACING.
YES ❑ NO ❑ INITIAL
LEGEND:
O
CHANNELIZING DEVICE
r
FLAGGING STATION
PORTABLE SIGN AND SUPPORT
®®
WOR'T VEHICLE WITH FLASHING
LIGWORK
AREA
SIDEWALK CLOSURE
(PEDESTRIAN DETOUR)
co n-
I �
Io
1
(L
V) Li
� W
N � Q
Y W Of Y
a
U)
� w
N
W
O
O O W
¢ 3
< >
216TH ST SW
I
I�
Iw
I�
RECEIVED
MAR 11 2024
I
�
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
SNOHOMISH COUNTY
GFMED
TRAFFIC CONTROL PLAN
PUBLIC UTILITY DISTRICT NO 1
PROJECT REPLACE (2) BO DISTRIBUTION POLES PLI 14347,
14348
LOCATION 21612 78TH AVE W,
EDMONDS 98026
ENGINEER K HAACK
DATE 3/11/24
ORDER 100128670
PHONE 425-670-3208
CELLULAR 425-238-7372
U
RECEIVED
MAR 11 2024
CITY OF EDMONDS
CITY OF EDMONDS M BuildingPermit.com
DEVELOPMENT
Right-o WaSIll0�ication #1455877 - WO 100128670 Replace 2 BO Distribution Pole:
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 98206-1107 (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
City Zip Code County Parcel Number
Associated Building Permit Number Tenant Name
Additional Information (i.e. equipment location or special instructions)_
Work Location
ROW at 21612 78th Ave W and on 216th St SW at 78th Ave W intersection
Property Owner
First Name Last Name or Company Name
Number Street Apartment or Suite Number
City State Zip
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: 3/11/2024 Submitted By: Moe Matthews
Page 1 of 2
CITY OF EDMONDS MyBuildingPermit.com
Right -of -Way Application #1455877 - WO 100128670 Replace 2 BO Distribution Pole:
Project Contact
Company Name: Snohomish County PUD
Name: Karl Haack Email: kjhaack@snopud.com
Address: 21014 63rd Ave W Phone #: (425) 238-7372
Lynnwood WA 98036
Project Type Activity Type Scope of Work
Utility Purveyor Utility Work Disturbance of Surface
Project Name: WO 100128670 Replace 2 BO Distribution Poles
PUD to replace 2 existing bad order 45' CL2 poles (PLI 14347 and 14348) with new 45' CL2
wood poles. Pole PLI 14347 to be set behind sidewalk. 3 separate day partial lane closure of
Description of westbound 216th at intersection of 78th Ave W and 216th St SW between the hours of 8:00am
Work: and 4:00pm. 2 separate day partial lane closure of southbound 78th Ave W at intersection of
78th Ave W at intersection of 78th Ave W and 216th St SW between the hours of
8:00am-4:00pm. No tree trimming required. No pavement cuts. Soft surface work on both poles.
Traffic control and pedestrian detour by PUD.
Project Details
Project Information
Job Number
100128670
Page 2 of 2