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APPROVED ENG2024-0300 ROW PERMITRIGHT OF WAY EUC PERMIT PERMIT NUMBER City of • • . www.edmondswa.gov i Description: PSE-ANNUAL INSPECTION OF 4 WIRE BOXES ON EDMONDS WAY ISSUED: 07/23/2024 Address: 10000-10016 EDMONDS WAY EDMONDS WA 98020 EXPIRES: 01/23/2025 OF WAY EUC Permit Subtype: MINOR Parcel Number: 00610700200803 iaType:Permit i NAME TYPE NAME ADDRESS PHONE APPLICANT COURTNEY XIONG 6500 URSULA PL S, SEATTLE WA 98108 (206)348-0676 CONTACT PUGET SOUND ENERGY 6500 URSULA PL S, SEATTLE WA 98108 (206)348-0676 CONTRACTOR PSE/INFRASOURCE 1660 PARK LANE, BURLINGTON WA 98233 (425)466-4771 OWNER WESTGATE VILLAGE LLC 4025 DELRIDGE WAY SW STE 350, SEATTLE WA 98106 FEE INFORMATION DESCRIPTION AMOUNT PAID CITY TECHNOLOGY FEE - PER PERMIT $45.00 $45.00 ENG - INSPECTIONS - 4.1.24 $264.00 $264.00 ROW - MINOR - 4.1.24 $132.00 $132.00 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: 07/23/2024 Printed: Tuesday, July 23, 2024 10:36:11 AM 1 of 2 RIGHT OF WAY EUC PERMIT PERMIT NUMBE3 City of Edmonds ,...Ave N, Edmonds WA 9:01 1 11 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, July 23, 2024 10:36:11 AM 2 of 2 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. RECEIVED Jun 17 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 887033545 - 2219711 Site Address or if no site address use Property Address at NW corner of project area: 10000-10016 Edmonds Way, Edmonds 98020 Associated Permits: BLD PLN I ENG X Owner and Entity Holding• .• - Name of Company Puget Sound Energy Franchise Ordinance No: Point of Contact Courtney Xiong Title Program Maintenance Coordinator Address 6500 Urusla PI S City Seattle State wA Zip 9108 Phone 206-348-0676 Email courtney.xiong@pse.com Contractor and Authorized Agent of Owner Name of Company Puget Sound Energy (see note below) Contractor Contacts During Construction Primary Name Courtney Xiong Agent Name Courtney Xiong Title Program Maintenance Coordinator Title Program Maintenance Coordinator Mobile 206-348-0676 Address 6500 Urusla PI S Email courtney.xiong@pse.com City Seattle State WA Zip 98108 Secondary Name Phone 206-348-0676 Title Email courtney.xiong@pse.com Mobile City of Edmonds Business License No: Email State License No: PUGETSE032J1 x 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? iR Other, please specify: gas maintenance work ❑ 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 ix 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.) Perform yearly inspection at wire box at 4 locations. Location 1: 560' W c/I 100 Ave W & 20' S c/1 Edmonds Way. Location 2: 21' N c/1 Edmonds Way & 19' W c/I 100 Ave W. Location 3: 21' N c/1 Edmonds Way & 28' W c/I 100 Ave W. Location 4: 23' N c/1 Edmonds Way & 24' W c/1 98 Ave W. Non -disturbance. Duration: approx. 15 minutes per location. RIGHT-OF-WAY CLOSURE AREA TOTAL DURATION (Number of Months) Sidewalk 72 hours + LF JxJ LF SF Alley 72 hours + LF JxJ F SF Parking 72 hours + LF JxJ 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 5d gas ❑ water ❑ sewer ❑ storm Details 1. of Work to be Completed Does the utility owner have existin overhead infrastructure in the area of work? 2. Will an e ui ment be added under round or above round (e. edestals, vaults, etc.)?If es, describe: 3. Does the proposed work connect a lot or commercial development with utilities that serve more than one lot or commercial develo ment? tx 4. Does the work involve rebuilding or relocating an existing aboveground utility system which connects a lot or commercial develo ment to an existin under round common utili s stem? 5. Does the work involve proposed additions to an aboveground utility system? 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 • to be Completed Me 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: X 6a. Does your project involve wires/cables/lines? If yes: X How many are existing? I I How many are to be added? 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: 06/14/2024 APPLICANT PRINTED NAME: Courtney Xiong APPLICANT TITLE: Program Maintenance Coordinator NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021 RECEIVED Jun 17 2024 PRE -INSPECTION REPORT Job #: 887033545 © CITY OF E SERVI DEVELOPMENTT SERVICES Date: 6/14/24 Address: 10000-10016 Edmonds Way DEPARTMENT Jurisdiction: Edmonds City / Zip: Edmonds 98020 Right of Way Permit? ❑✓ YES ❑ No Customer: Est. Start Date: 07/16/24 PM / Insp: Courtney Xiong CUST PHONE NUMBER 206-348-0676 Est. Duration: 1 Day PHONE NUMBER Construction Method WORK DESCRIPTION: Trenchless ❑ Perform yearly inspection at wire box and get read at 4 locations Duration: Approx. 15 mins at Open Trench ❑ each location. New Construct ❑ Existine 0 SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM N 11 WIS.' Nam:- 11 1 . -. ' 'I-! =i 11111111121111111111111111011111111 o t I _ 9 •' - Applicant shall repair/replace all „ zz oa ri- tom i 2zet W damage to utilities or frontage improvements in City right-of-way per city standards that is caused or occurs during the permitted project. TS-032991 �?,1 < o m Location: ENGINEERING DIVISION 560' W c11 100 Ave W & .�f; �;A� �'- 9� PAPPROVED AS NOTED 20' S cll Edmonds Way ' 07/23/2024 ' 22829 N, 1 0 ` Q TS-051736 1971 992 rt Location: a a 28'Wc11100Ave W& rr 21' S cll Edmonds Way "0 F. TS-051735 Location: 19' W cll 100 Ave W & '• . 21' S cll Edmonds Wa ,.. mony .7 M TS-032911 AY 9804 Location: '_ ' 24' W cll 98 Ave W & H s z a EXISTING 4" GA$.MAIIN f,T y� �«, 23' S c/I Edmonds Way V, Work Location Size of Cut Surface Type 'N S of CL & 'E W of CL 'N S of CIL 8, 'E W of CL 'N S of CL & 'E W of CL ❑ FLAGGERS # MPH ❑ TROLLY LINES ❑ BUS STOP # ❑ METER HOODS # ❑ OFFICERS # SPEED LIMIT ❑ TRAFFIC SIGNAL ❑ ARTERIAL ❑ NO PARKS # ❑ Commercial ❑ Altered Commercial ❑ Leak Repair Service Information ❑ Template Bar ❑ Residential ❑ Altered Residential ❑✓ CP Work Diameter Meter EFV Pressure ❑ Bollards 2.5" # ❑ Multi -Family ❑ Replacement Service ❑ Pothole ❑ 5/8" ❑ 250 ❑ 1800 ❑ 6" WC El Bollards 4" # ❑ New Constr. ❑ Main Maintenance ❑ Extension El11/8" ❑ 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: 71n8iA Or10?JHl SN oa�o� -0 ,c LEGEND TRAFFIC BARRELS WITH BEACONS ® BORE PIT TRAFFIC FLOW WORK VEHICLE SIGN LOCATION WARNING FLAG ARROW BOARD a� ono •r�� � �H�s USE STEADY TRAFFIC \ \ BARRELS WITH BEACONS \ \ •o • \ • •goo v. do l�iS SI �INOZ N1 JO �18 ­l­l`dHS NOU3 MINIMUM TAPER LENGTH = L (feet) LANE POSTED SPEED LIMITS WIDTHS 25 30 35 40 45 10 105 150 205 295 475 11 ]80 115 165 225 295 495 12 125 180 245 320 540 E. � 7210 '' � ILJ��'VI 'i ISO 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. 4. Sign size can be a minimum of 48" x 48" 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. 8. Work area will be 20' SCL of Edmonds Way at 560' WCL of 100th Ave W. 9. If used, place NO -PARK signs 72 hours in advance of the day that the work is to be done. Ina�nj SIGN SPACING "X" 55 + 800 60/65 500' 45/55 350' 35/40 200' 30 100' 25 PUGET ' SOUND ENERGI Job# 887033545 Edmonds Way & 100th Ave W, Edmonds, WA September 26, 2016 Sheet 1 of 3 gregory.harwood@pse.com (425) 424-642E %tj I e............. •••• _CU'1 e • e _... .... .•••.... •••• •••• •••• •••• e ---------------------------- - I _ I - I I I - I - - OV3H`d INO01 3d0N1a71nE7AYV HenMJH1 SNOU0 , `0 3 Galr•I fv OV3HV X O 03SO10 3NVIiHOIa � bib a144 I X' 1111 �sii�>> r I I 0 • II x' I I .00 o•= \ 4 / ­4do 13S SI 9NO J.21n9N3 I I�I I I LLI I� I 39 IIVH I CT i WI h�211 Ol�d`d211 �ooOO1b1 Ia13 1I141 141 - ; YQ to 6p m w2 1 96-�t70 D CO tooW • CO� _X • . ao 7ov � � e LEGEND ,q ® 28" TRAFFIC CONE ® TRENCH o TRAFFIC FLOW POLILC UNIFORMED ' m POLICE OFFICER �I FFLAGGER 1 I 11 WORK VEHICLE tiZOZ/£Z/LO SIGN LOCATION adlON SV G�IAOadd`d WAR I§N(] ONI2EEINIONq I I ARROW BOARD I I I I I 1N3W1aVd30 S301A213S 1N31NdM3A3G SONOW03 30 AlIO 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. 4. Sign size can be a minimum of 48" x 48" 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. 8. Work areas will be 19' & 28' WCL of 100th Ave W at 21' NCL of Edmonds Way. 9. If used, place NO -PARK signs 72 hours in advance of the day that the work is to be done. USE STEADY TRAFFIC BARRELS WITH BEACONS 000 •0- • PUGET SOUND ENERGI Job#887033545 Edmonds Way & 100th Ave W, Edmonds, WA September 26, 2016 Sheet 2 of 3 gregory.harwood@pse.com (425) 424-6425 VL-OZZM / _ \�Z-vm • '----------------------- -------X --- -- X--- -- X--- -- X--- --------------------- ........ ......, •.,.,.,.•........ .... — -- — — — — — — — — — — — — — — — — — — — — — — — — — — — — • c — ----C—CURB— — ——— — — — — — — — — — — --- - _... ..... � ........ ... ............ .... ........ .. ........ .. ... .... .... .... .... .... ........ .... ............ .... ........ .... .......... ............ ........ ........ ......... b ------ ------ -------------- -°Sp-°--W°-Wa------------------------------------- EDMONDS EDMONDS WAY (SR 104) STOP I I Q I II o C\j I BE � PREPARED X ; TO STOP ROAD o I b I = WORK �, 1 AHEAD SIGN SPACING 55 + "X" 60/65 800 45/55 500' 35/40 350' 30 200' 25 100, CHANNELIZATION DEVICE SPACING MPH TAPER TANGENT 55/70 40 80 35/45 30 60 25/30 20 40 MINIMUM TAPER LENGTH = L (feet) LANE POSTED SPEED LIMITS WIDTHS 20 25 30 35 40 45 10 70 105 150 205 295 475 11 75 115 165 225 295 495 12 i 80 125 180 245 320 540 I I Q I II o C\j I BE � PREPARED X ; TO STOP ROAD o I b I = WORK �, 1 AHEAD SIGN SPACING 55 + "X" 60/65 800 45/55 500' 35/40 350' 30 200' 25 100, CHANNELIZATION DEVICE SPACING MPH TAPER TANGENT 55/70 40 80 35/45 30 60 25/30 20 40 MINIMUM TAPER LENGTH = L (feet) LANE POSTED SPEED LIMITS WIDTHS 20 25 30 35 40 45 10 70 105 150 205 295 475 11 75 115 165 225 295 495 12 i 80 125 180 245 320 540 SIGN SPACING 55 + "X" 60/65 800 45/55 500' 35/40 350' 30 200' 25 100, CHANNELIZATION DEVICE SPACING MPH TAPER TANGENT 55/70 40 80 35/45 30 60 25/30 20 40 MINIMUM TAPER LENGTH = L (feet) LANE POSTED SPEED LIMITS WIDTHS 20 25 30 35 40 45 10 70 105 150 205 295 475 11 75 115 165 225 295 495 12 i 80 125 180 245 320 540 CHANNELIZATION DEVICE SPACING MPH TAPER TANGENT 55/70 40 80 35/45 30 60 25/30 20 40 MINIMUM TAPER LENGTH = L (feet) LANE POSTED SPEED LIMITS WIDTHS 20 25 30 35 40 45 10 70 105 150 205 295 475 11 75 115 165 225 295 495 12 i 80 125 180 245 320 540 MINIMUM TAPER LENGTH = L (feet) LANE POSTED SPEED LIMITS WIDTHS 20 25 30 35 40 45 10 70 105 150 205 295 475 11 75 115 165 225 295 495 12 i 80 125 180 245 320 540 Jf102iH SN01103dSNl T1`d 31f143HOS 3HAA a�njlna�i�j d1NO3 0Idjb2:11 Q W20-1 LEGEND . TRAFFIC BARRELS WITH BEACONS ® BORE PIT TRAFFIC FLOW FLAGGER O1T1� I ANT23 [ON WARNING FLAG M ARROW BOARD PUGET ' SOUND ENERGI Job#887033545 Edmonds Way & 100th Ave W, Edmonds, WA �OZM September 26, 2016 0 0 Sheet 3 of 3 gregory.harwood@pse.com odyo�ya oodo0_ (425) 424-642F USE STEADY i �.• ' i TRAFFIC BARRELS WITH BEACONS w KEEP HALF OF ,"-' '"" '• /• Q WELLS FARGO - = EGRESS OPEN - - ----- -- ........ i o- . ........... • ..� •� ..= — — I � O -----------'- a Qo��QO ............------------- --- --R 104) N b -A EDMONDS WAY (S MINIMUM TAPER LENGTH = L (feet) LANE POSTED SPEED LIMITS WIDTHS 20 25 30 35 40 45 10 70 105 150 205 295 475 11 75 115 165 225 295 495 12 80 125 180 245 320 540 CHANNELIZATION DEVICE SPACING TANGENT TAPER MPH 80 40 55/70 60 30 35/45 40 20 25/30 97TH AVE SW \ I SIGN SPACING "X" 55 + 800 60/65 500' 45/55 350' 35/40 200' 30 100, 25 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. 4. Sign size can be a minimum of 48" x 48" 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. 8. Work area will be 23' NCL of Edmonds Way at 24' WCL of 98th Ave W (Esm't) 9. If used, place NO -PARK signs 72 hours in advance of the day that the work is to be done. 1N31N12iVd34 S�:�IhN�S IN�Wri C)��n�Cl RECEIVED Jun 17 2024 CITY OF EDMONDS , MyBuildingPermit.com DEVELOPMENT SERVICES CITY OF EDMONDS DEPARTMENT Right -of -Way Application #1504467 - PSE - 10000-10016 Edmonds Way Applicant First Name Last Name Company Name Courtney Xiong Puget Sound Energy Number Street Apartment or Suite Number E-mail Address 6500 Ursula PI S courtney.xiong@pse.com City State Zip Phone Number Extension Seattle WA 98108 (206) 348-0676 Contractor Company Name PUGET SOUND ENERGY INC Number Street Apartment or Suite Number 6500 Ursula PL S City State Zip Phone Number Extension Seattle WA 98108 (206) 716-2641 State License Number License Expiration Date UBI # E-mail Address PUGETSE032J 1 3/20/2026 179n 1 M55 courtney.xiong@pse.com 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 10000-10016 Edmonds Way 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: 6/14/2024 Submitted By: Courtney Xiong Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Right -of -Way Application #1504467 - PSE - 10000-10016 Edmonds Way Project Contact Company Name: Puget Sound Energy Name: Courtney Xiong Email: courtney.xiong@pse.com Address: 6500 Ursula PI S Phone #: (206) 348-0676 Seattle WA 98108 Project Type Activity Type Scope of Work Utility Purveyor Utility Work No Disturbance of Surface Project Name: PSE - 10000-10016 Edmonds Way PSE Job# 887033545 - 2219711 Perform yearly inspection of wire box at 4 locations. Location Description of 1: 560ft W c/I 100 Ave W and 20ft S c/I Edmonds Way. Location 2: 21ft N c/I Edmonds Way Work: and 19ft W c/I 100 Ave W. Location 3: 21ft N c/I Edmonds Way and 28ft W c/I 100 Ave W. Location 4: 23ft N c/I Edmonds Way and 24ft W c/I 98 Ave W. Non -disturbance. Work duration: approx. 15 minutes per location. Project Details Project Information Job Number 887033545 Page 2 of 2