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APPROVED ENG2024-0513 ROW PERMITOF WAY PERMIT PERMIT ER City •EdmondsRIGHT 98020 ENG2024-0513 www.edmondswa.gov i Description: ROW - POTHOLE TO VERIFY NO CROSSBORE IN SEWER LINE ISSUED: 11/26/2024 Address: 9322 232ND ST SW EDMONDS WA 98020-5026 EXPIRES: 05/26/2025 rmit Type: RIGHT OF WAY Permit Subtype: RESIDENTIAL Parcel Number: 27033600108700 i NAME TYPE NAME ADDRESS PHONE APPLICANT PHELAN MCGREW 2825 S 154TH ST, SEATTLE WA 98188 (971)217-3383 CONTACT PHELAN MCGREW 2825 S 154TH ST, SEATTLE WA 98188 (971)217-3383 CONTRACTOR PRICOR TECHNOLOGIES 2825 S 154TH ST, SEATTLE WA 98188 (206)258-5270 OWNER RICHARD & DONNA MARIE KERNS 9322 232ND ST SW, EDMONDS WA 98020 FEE INFORMATION DESCRIPTION AMOUNT PAID CITY TECHNOLOGY FEE - PER PERMIT $45.00 $45.00 ENG - INSPECTIONS - 4.1.24 $264.00 $264.00 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: 11/26/2024 Printed: Tuesday, November 26, 2024 4:12:16 PM 1 of 2 RIGHT OF WAY 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 X-2 ENGINEERING FINAL** A-1 JOB START E-7 TRAFFIC CTRL Printed: Tuesday, November 26, 2024 4:12:16 PM 2 of 2 RECEIVED 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. Nov 05 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. SECTION A Owner and Entity Holdingapplicable) Name of Company , C. ^ C Franchise Ordinance No: Point of Contact Title M w .v- Address .22Z S S S h St City S-f'yaz_ State Zip 4( gl Phone -2- Email PM c_ Gr 7°f /'Cow Tcu,. ca,,, Contractor and Authorized Agent of •wner (see note •• •w) Name of Company T_Co s- Contractor ContactsDuring Construction Primary Name Agent Name Title Title Mobile Address Email City State Zip Secondary Name Phone Title Email Mobile / S City of Edmonds Business License No: k 024 �-�J Email State License No: �r ; / / 2 Contractor verifies it is currently bonded e- 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. —Typeof Development apply ❑ Multifamily residential ❑ Commercial ❑ City project ❑ Single family residential subdivision a -Single family -other ❑ Industrial ❑ Demo and rebuild or from vacant land? ❑ Other, please specify: V 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) 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.) �0f�/t Sewer oL 64.< TG LF N0 <M55�eie. RIGHT-OF-WAY CLOSURE AREA TOTAL DURATION (Number of Months) Sidewalk 72 hours + LF x LF SF Alley 2 hours + LF x LF SF FParking 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. •- of Facilities1. The work in the right of way is on or for the following type of facilities: ❑ telecommunications ❑ cable ❑ power j? gas ❑ water X sewer ❑ storm Details of Work to be Completed Yes No i. I Does the utility owner have existing overhead infrastructure in the area of work? ! 2. 1 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 CompletedNo 6. 1Does 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? I I How many are to be added? 6b. Does your project involve poles? If yes: l 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: 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 owne o this application. Fees. The Applicant is responsible for r it fees. APPLICANT SIGNATURE: DATE: G 3 2 y APPLICANT PRINTED NAME:. 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 SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM TRAFFIC CONTROL INSPECTION SHALL BE REQUIRED WHENEVER WORK ZONE IS SET UP SIGNAGE AND FLAGGERS PER WSDOT AND MUTCD STANDARDS SHALL BE USED WHEN A LANE IS CLOSED. OWNER/CONTRACTOR IS RESPONSIBLE FOR EROSION CONTROLAND DRAINAGE OWNER/CONTRACTOR RESPONSIBLE FOR LOCATING ALL ON SITE UTILITIES. RELOCATION/REVISION TO ANY UTILITIES MAY REQUIRE A SEPERATE PERMIT. RECEIVED Pothole gas and sewer and gas next Nov 05 2024 to the mail box in CITY OF EDMONDS dirt to verifiy no DEVELOPMENT SERVICES cross bore DEPARTMENT RESTORATION LIMITS TO BE DETERMINED BY CITY ENGINEERING INSPECTOR IF ANY PORTION OF 232ND ST SW IS UNDERMIND A FULL LANE ASPHALT REPLACEMENT SHALL BE REQUIRED. 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. ENGINEERING DIVISION APPROVED AS NOTED Jell "X I ,,4z 11 /22/2024 ko -40 I5 I .,+\• s .. S. F•�(e �1i q F, •'%./. �, tom♦ '`- � 1,. r L' ^�' � ��' '`a,}, �1 ,� t� I K ,' !. r. 1 FI('' /?I7r :1 �'8rr''�'���1 ..•1 J •' `•• All eo 44 -'`A►'�'• w, � - �� � +, � 11 s. 1 �< �.y{ �.,•iER a :. •. � .. I -aw '. i��.• � `•.s .1�_ \ •, at""�'1 x�a 'tom �I ��,�.f\��Fri. �T .� I .; / - �' `:� 1 .\ -i 13 if �•rs �.-. } + ., - Mr. bow F tz i ( 'C 7tf r t �H�• At K� T'J W l E �+t,E ,• Jf ."J,y{-I/w•'FeRiil�� 1� 1+'�' ip RECEIVED CITY OF EDMONDS Right -of -Way Application #1568436 - 9322 / Nov 05 2024 MyBuildingPermit.com CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT Applicant First Name Last Name Company Name Phelan Mcgrew Phelan McGrew Number Street Apartment or Suite Number E-mail Address 2825 S 154th St pmcgrew@pricortech.com City State Zip Phone Number Extension Seattle WA 98188 (971) 217-3383 Contractor Company Name PRICOR TECHNOLOGIES LLC Number Street Apartment or Suite Number 2825 SOUTH 154TH STREET City State Zip Phone Number Extension SEATTLE WA 98188 (206) 258-5270 State License Number License Expiration Date UBI # E-mail Address PRICOTL865KZ 5/14/2026 Fn:3iAF;s.m pmcgrew@pricortech.com Project Location Number Street Floor Number Suite or Room Number 9322 232ND ST SW City Zip Code County Parcel Number EDMONDS 98020 27033600108700 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 Richard & Donna Marie Kerns Number Street Apartment or Suite Number 9322 232ND ST SW 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: 10/30/2024 Submitted By: Phelan Mcgrew Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Right -of -Way Application #1568436 - 9322 Project Contact Company Name: Phelan McGrew Name: Phelan Mcgrew Address: 2825 S 154th St Seattle WA 98188 Email: pmcgrew@pricortech.com Phone #: (971) 217-3383 Project Type Activity Type Scope of Work Single Family Residential New Excavation and Utility Work Project Name: 9322 Description of Work: Pothole Sewer in the dirt shoulder to verify no gas crossbore Project Details Project Information Utility Service Installation Impervious Surface Adding/Replacing less than 2,000 square feet of hard surface Clearing and Grading Information This is neither new development nor redevelopment. Tree Removal There are no significant trees being removed Page 2 of 2