APPROVED ENG2024-0552 ROW PERMITRIGHT OF WAY MINOR PERMIT
A PERMIT NUMBE
City of Edmonds
il
98020 ENG20244-055
www.edmondswa.gov i
Description: ROW - USE OF ROW TO BORE NEW WATER SERVICE LINE ISSUED: 12/09/2024
Address: 1123 9TH AVE S EDMONDS WA 98020-3963
EXPIRES: 06/09/2025
Permit Type: RIGHT OF WAY MINOR Permit Subtype: RESIDENTIAL Parcel Number: 27032500111100
CONTACTS
NAME TYPE NAME ADDRESS PHONE
APPLICANT HEATH SHOCKMAN 19505 24 STE 104, LYNWOOD WA 98036
(206)734-8444
CONTACT A -LIST PLUMBING LLC 19505 24 STE 104, LYNWOOD WA 98036
(206)734-8444
CONTRACTOR A -LIST PLUMBING 21133 22ND AVE W, LYNNWOOD WA 98036
(206)734-8444
OWNER LAURENCE & MONTEREY 1123 9TH AVE S, EDMONDS WA 98020-3963
ROBERTSON
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: 12/09/2024
Printed: Monday, December 09, 2024 8:56:05 AM 1 of 2
RIGHT OF WAY MINOR PERMIT
PERMIT NUMBE
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**
E-7 TRAFFIC CTRL
Printed: Monday, December 09, 2024 8:56:05 AM 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 E6.
DEC 04 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
Project Name Monterey
Site Address or if no site address use Property Address at NW corner of project area: 1123 9th Ave S Edmonds, Wa 98020
Associated Permits:
BLD
PLN
ENG
Name of Company
Franchise Ordinance No:
Point of Contact
Title
Address
City
State
Zip
Phone
Email
1
-� • - �-ro
Name of Company A -List Plumbing
Primary Name
Agent Name Heath Shockman
Title
Title Plumber
Mobile
Address 19505 24th Ave West STE104
Email
City Lynwood
State WA
Zip 98036
Secondary Name
Phone 2o67348444
Title
Email admin@alistplumbing.com
Mobile
City of Edmonds Business License No: 604-972-627-001-0001
Email
State License No: 604972627
X❑ Contractor verifies it is currently bonded
X❑ 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
❑ Multifamily residential ❑ Commercial ❑ City project x 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
uwM ❑ 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.)
Opening up 3'x4' area at the northwest corner of driveway and directional drilling new water line to foundation.
Patching after inspection
40" foot water line from meter to house foundation
RIGHT-OF-WAY
CLOSURE
AREA
TOTAL
DURATION
(Number of Months)
Sidewalk 72 hours +
LF
x
LF
SF
Alley 72 hours +
LF
x
LF
SF
Parking 72 hours +
LF
x
LF
SF
SECTION B - I you are not a utility company er ormin work in the City ROW, skip to SECTIONC.
1. The work in the right of way is on or for the following type of facilities: :
❑ telecommunications ❑ cable ❑ power ❑ gas ❑ water ❑ sewer ❑ storm
IMP
1.
Does the utility owner have existing 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 yes:
Are the additions for the purpose of serving new commercial development?
Are the additions for the purpose of serving a single-family residential subdivision?
�- • • ••• • •--•
!=•
z
6
Does your project involve rebuilding or replacing utility equipment which currently serves
more than one lot or commercial development?
Ci of Edmonds ROW construction permit Application --Page 2 of 3 Updated 2 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?
How many are to be added?
6b.
Does your project involve poles? If yes:
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 placed?
How many?
What is the height of the additional poles?
Are any poles to be modified/rebuilt/replaced? If yes:
How many?
TFZ
at is the height of the poles after?
Describe the modification/rebuild:
SECTION C
erms
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: Heath Shockman DATE: 12-
APPLICANT PRINTED NAME: Heath Shockman
APPLICANT TITLE: A -List Plumbing Owner
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021
www.invarion.com
10 Feet I 11 Feet I 12 Feet I Shoulder
Tapers
RECEIVED
DEC 04 2024
Sign Spacing
Legend
Freeways & Expressways
55/70 MPH
1500' +/-
Cone
Flagger
No Parking Sign
. W20-1 Road Work Ahead
W20-4 One Lane Road Ahead
Rural Highways
60/65 MPH
800' +/-
Rural Roads
45/55 MPH
500' +/-
Rural Roads & Urban Arterials
35/40 MPH
350' +/-
Rural Roads, Urban Streets
25/30 MPH
200' +/-
Residential & Business Districts
♦ W20-7 Flagger
Urban Streets
25 MPH or LESS
100' +/-
® Work Area
WORK -------
HEAD
200 ft
ONE LANE
ROAD -------
AHEAD
Fir St
200 ft
100 ft
ROAD
•
WORK ■T/
AHEAD A
200 ft
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
No Parking signs to
be placed 72 hours
in advance
Notes:
1. All signs and spacing to conform to the MUTCD and WSDOT
guidelines.
2. Notify property owners in advance. Contractor shall coordinate with
residents for DWY access
3. "Road Work Ahead" signs to side roads/driveways if needed.
4. Maintain 10' minimum lane widths at all times.
5. Traffic control devises shall not encroach into adjacent lanes.
6. The distances shown on the traffic control plans are desirable
minimum requirements. Device spacing, buffer space and sign
spacing might require adjustments based on Feld conditions.
7. Work to take place between 9 a.m and 4p.m unless otherwise
specified. All work for arterials and major roadways will be from 9 a.m
to 3 p.m.
TRAFFIC CONTROL INSPECTION SHALL BE
REQUIRED WHENEVER WORK ZONE IS SET UP
►__ Flaggers to watch for
pedestrians and
maintain access/exit to
driveways. Contractors
to notify residents prior
to work being done.
j= ENGINEERING DIVISION
Applicant shall repair/replace all
damage to utilities or frontage
improvements in City right-of-way r(I� 2/06/2024
per city standards that is caused or — �V
occurs during the permitted project.
OWNER/CONTRACTOR IS RESPONSIBLE FOR
--- EROSION CONTROL AND DRAINAGE
OWNER/CONTRACTOR RESPONSIBLE FOR LOCATING t
p 50-100 ft ALL ON SITE UTILITIES. RELOCATION/REVISION TO ANY
UTILITIES MAY REQUIRE A SEPERATE PERMIT.
A Taper
M
s p 11239th Ave S
y p Edmonds, WA
m A
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m p • PARKING
Z o
4
p 50-100 ft
p � Taper
200 ft
■
200 It
ONE LANE
ROAD
AHEAD ROAD
WORK
AHEAD
-100 ft
200 ft '
ROAD
WORK
Sea Vista PI
Date: 11/26/2024 Author: Christian Matthews Project: 1123 9th Ave S Edmonds, Wa 98020 This TCP is "stand
Company: A -List Plumbing Contact: Heath Shockman Phone: 805.403.2710 alone" and shall not
Comments: be active concurrently
with any other TCP.
1nulun rnNr'/u`
MAXIMUM CHANNELIZATION
DEVICE SPACING (feet)
WASHINGTON STATE TRAFFIC CONTROL
SUPERVISOR
I.D. N,,. 17013E
card N,,. Eg2 000482
Nam, ChristianMamemJ,_
Datearesplrntl,rn 4/30/2028
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Permit:
Work Hours
from
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MPH
TAPER
TANGENT
50/65
40
80
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35/45
30
60
20/30
20
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RECEIVED
DEC 04 2024
CITY OF EDMONDS
Right -of -Way Application #1584932 - Water Service
MyBuildingPermit. corn
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
Applicant
First Name Last Name Company Name
Heath Shockman A -List Plumbing LLC
Number Street Apartment or Suite Number E-mail Address
19505 24 STE 104 admin@alistplumbing.com
City State Zip Phone Number Extension
Lynwood WA 98036 (206) 734-8444
Contractor
Company Name
A -List Plumbing LLC
Number Street Apartment or Suite Number
19505 24th Ave West Ste 104
City State Zip Phone Number Extension
LYNNWOOD WA 98036 (206) 734-8444
State License Number License Expiration Date UBI # E-mail Address
LISTPPL774Q8 12/18/2025 FD4g79F;97 admin@alistplumbing.com
Project Location
Number Street Floor Number Suite or Room Number
1123 9TH AVE S
City Zip Code County Parcel Number
EDMONDS 98020 27032500111100
Associated Building Permit Number Tenant Name
Water Service
Additional Information (i.e. equipment location or special instructions)_
Work Location
Property Owner
First Name Last Name or Company Name
Laurence & Monterey Robertson
Number Street Apartment or Suite Number
1123 9TH AVE S
City State Zip
EDMONDS WA 98020-3963
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: 12/3/2024 Submitted By: Heath Shockman
Page 1 of 2
i
CITY OF EDMONDS MyBuildingPermit.com
Right -of -Way Application #1584932 - Water Service
Project Contact
Company Name: A -List Plumbing LLC
Name: Heath Shockman Email: admin@alistplumbing.com
Address: 19505 24 STE 104 Phone #: (206) 734-8444
Lynwood WA 98036
Project Type Activity Type Scope of Work
Single Family Residential Modification Excavation and Utility Work
Project Name: Water Service
Description of Work: Installing a new water service line
Project Details
Impervious Surface
Adding/Replacing less than 2,000 square feet of hard
surface
Tree Removal
There are no significant trees being removed
Page 2 of 2