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APPROVED ENG2024-0316 ROW PERMITRIGHT OF WAY EUC PERMIT PERMIT NUMBER City of • • . 98020 ENG2024-03166] www.edmondswa.gov i Description: ZIPLY-TRENCH FROM POLE TO SUBJECT PROPERTY ISSUED: 12/10/2024 Address: 7411 241ST ST SW EDMONDS WA 98026 EXPIRES: 06/10/2025 rmit Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 00488800601002 I 11-14111 a i i NAME TYPE NAME ADDRESS PHONE APPLICANT ARRIANNE MOMMSEN 426 E CASINO ROAD, EVERETT WA 98208 (402)670-8384 CONTACT ZIPLY FIBER NORTHWEST LLC 426 E CASINO ROAD, EVERETT WA 98208 (402)670-8384 CONTRACTOR PACIFIC CABLE CONSTRUCTION INC PO BOX 573, WOODINVILLE WA 98072 (425)348-7735 OWNER DAVIS JARED & SMITH COURTNEY 7411 241ST ST SW, EDMONDS WA 98026 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: 12/10/2024 Printed: Tuesday, December 10, 2024 9:57:45 AM 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** E-7 RESTOR LIMITS Printed: Tuesday, December 10, 2024 9:57:45 AM 2 of 2 RESUB 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. NOV 20 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 Site Address or if no site address use Property Address at NW corner of project area: 7411 24th ST 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: Point of Contact Mike H a ka h a n Title Engineer Address426 E Casino Rd. city Everett State WA zip 98208 Phone 425-949-0230 Email mike.hakahan@ziply.com Contractor and Authorized Agent of Owner (see note below) Name of Company Pacific Cable Construction Contractor Contacts During Construction Primary Name Luke Jones Agent Name Luke Jones Title Permit Manager Title Permit Manager Mobile 425-348-7735 AddressPO Box 573 Email luke@paccab.com city Woodinville State WA zip 98072 Secondary Name Phone 425-348-7735 Title Email luke@paccab.com Mobile City of Edmonds Business License No: PACI FCC954PJ Email State License No: PACI FCC954PJ E3 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 FROM POI F ON RIGHT sinF OF AnnRFSS 7430 HAN net ji I ING ACROSS PRIVATF DRIVEWAY 30FT TO FP ON LEFT OF ADDRESS 7516 THEN BORING 38FT ACROSS STREET TO FP ON LEFT OF ADDRESS 7411 241 T ST SW FROM FP ON LEFT OF ADDRESS 741 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 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? I I 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 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? 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: va�uc (_ u u�t-r� DATE: 10/25/2024 APPLICANT PRINTED NAME: Dorothy Graham APPLICANT TITLE: TCP & Permit Specialist 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 RESUB LEGEND: j D EXISTING TERMINAL FTM-1 PROPOSED TERMINAL EXISTING UTILITY POLE ® PROPOSED NEW POLE H H 1 EXISTING HANDHOLE H H PROPOSED NEW HANDHOLE [2'x3'] M H EXISTING MANHOLE EH PROPOSED NEW MANHOLE 0 EXISTING FLOWER POT © PROPOSED NEW FLOWER POT - — EXISTING UNDERGROUND UTILITY PROPOSED UNDERGROUND — — — CONSTRUCTION [HAND DIG, BORE] EXISTING AERIAL SPAN PROPOSED AERIAL SPAN CENTER LINE — — PARCEL LIMITS [PROPERTY LINE] EOP EDGE OF PAVEMENT ROW RIGHT OF WAY SANITARY SEWER WATER STORM SEWER ® POT HOLING OWNER/CONTRACTOR IS RESPONSIBLE FOR EROSION CONTROL AND DRAINAGE MINIMUM STANDARDS FOR DIRECTIONAL BORING STREET CROSSINGS Utility patches shall be combined and full width or half width overlay will be required depending on the extent of disturbance. Where utility patches fall entirely within one travel lane, the overlay shall extend to the centerline of roadway. Where utility patches extend into both travel lanes then a full width overlay is required. DMONDS CITY =0 P I—r I EX. GRADE OWNER/CONTRACTOR RESPONSIBLE FOR LOCATING VICINITY MA ALL ON SITE UTILITIES. RELOCATION/REVISION TO ANY UTILITIES MAY REQUIRE A SEPERATE PERMIT. 48" MIN 12" MIN BORE PIT FROM EX. UTILITIES RECEIVE PIT WORK DETAILS: PLACE END MARKER WITH UTILITY OWNER'S NAME DESCRIBING CONDUIT BORE PIT TO BE BACKFILLED AND COMPACTED IN 12" LIFTS WITH MATERIAL REMOVED FLOW OF ANY NEARBY DRAINAGE MUST BE MAINTAINED AT ALL TIMES PROTECT ROOTS AT ALL TREE LOCATIONS, FIELD ADJUST AS NECESSARY FROM POLE ON RIGHT SIDE OF ADDRESS 7430 PULLING FIBER ACROSS PRIVATE DRIVEWAY 30FT TO FP ON LEFT OF ADDRESS 7516 THEN BORING 38FT ACROSS STREET TO FP ON LEFT OF ADDRESS 7411 THEN HAND DIG 64 FT TO LEFT C HOUSE 7411 241ST ST SW TYPICAL SOREOETA/LS I I NOV 20 2024 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT ..A 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. POT HOLES SHALL BE REQUIRED WHERE BORE PATH CROSSES ANY UNDERGROUND UTILITY EOP 19 ENGINEERING DIVISION APPROVED AS NOTED 12/04/2024 MM Know what bekm ,8 . Call before you dig O ATCO COMMUNICATIONS SERVICES, LLC www.otcoteiecom.com 360.563.9000 708 First Street Snohomish, WA 98290 Kfiber yett, WA 98206 C\I v co CD N rn W 3 Q = v CD Cl)- o z I Lti o N O LU o aLU I— N co z00 U ~ U F 4 N � N N W 1� Q U W Of Ik� O Z O C/) H U W m g W p 0 W Z Q ~ Z LLI U W U LLI U � Q Z O W O W Q W LU 0- D- z LL DATE: 11 /20/2024 DESIGNED BY: D. GRAHAM ATCO CONTACT: DOROTHY.GRAHAM@atcotelecom.com SCALE: SHEET: NOT TO 01 SCALE N0: 1 OF 1 EDMONDS • I Q "C WORK AREA-, FP �0 7'0`2 4.1 st•St-SW FP POLE , CD M eb 0 T. V VICINITY MAP ENGINEERING DIVISION APPROVED AS NOTED j%JJ (WA4, $,.,, 4z 12/04/2024 Vill RESUB NOV 20 2024 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT Al fto ATCO COMMUNICATIONS SERVICES, LLC www.atcotelecom.com 360.563.9000 708 First Street Snohomish, WA 98290 zipylfibe Everett, WA 98206 5 0 Lu a rn ao Q v Q N > > O 04 o 0 N Lu 0 J uJ Lu d z > ui U) O Lu of ~ U) Luw m w Lu m 7 N d W O Luw mw �M U z U Lu Q U Lu Z O LL1 Q Z 0 o U O � LL DATE: 11 /20/2024 REVIEWED BY: M. LUNA WTCS# 013184 DESIGNED BY: D. Graham ATCO CONTACT: 559-826-9359 Dorothy.Graham@atcotelecom.com SCALE: SHEET: NOT TO SCALE NO: 1 OF 3 SYMBOL LEGEND: OS SIGNALIZED INTERSECTION SIGN LEGEND: PHASE OCONE (CANDLESTICK) ® TYPE III BARRICADE ROAD SHOULDER O WORK WORK ATCO COMPAUNICATIONSSERVICES. LLC WORK TRUCK AHEAD www.atcatelecom.corn 9000 WORK ZONE LIMITS 08 First Street 708 First Street PORTABLE SIGN W20-1 W21-5 Snohomish, WA 98290 Q EXISTING SIGN e ® DRIVEWAYF(89 z I I f i b e r ARROW BOARD (WHERE REQUIRED) Everett, WA98206 DIRECTION OF TRAFFIC �•+" (NOT PAVEMENT MARKINGS) R8-3a 11 FLAGGER-SPOTTER O W 3 7411 co Q N FLAGGER STATION (j = Z O4 � 0 Q o uU * Q 241st STREET SW 1 ti N w Q J o WORK DETAILS: I co 25 MPH ^d cn 0- cn 241st STREET SW XW20-1 a J FROM POLE ON RIGHT SIDE OF ADDRESS 7430 HAND W O m PULLING ACROSS PRIVATE DRIVEWAY 30FT TO FP ON LEFT 25 MPH ��„ coOF ADDRESS 7516 THEN BORING 38FT ACROSS STREET TO FP ON LEFT OF ADDRESS 7411 241ST ST SW M co N 0 Z CONTRACTOR TO PLACE NO PARKING SIGNS ON BOTH W20-1 j O SIDES OF THE STREET 72 HOURS PRIOR TO START W21-5 WORK X X 40' � 40' SHOULDER TAPER DOWN STREAM O U SPOTTER NEEDED FOR PEDESTRIAN TRAFFIC p TAPER z AND DRIVEWAY ACCESS. t ; d 7516 w 7430 0LL Q Q U) wLL O % (V -_/ LU m W POT HOLES SHALL BE REQUIRED WHERE BORE co M LU PATH CROSSES ANY UNDERGROUND UTILITY maw Z 0 z co H H c ¢ NOTE: O LU � O Z NOTIFY RESIDENTS OF POTENTIAL of � W J DRIVEWAY CLOSURE 72 HOURS d a- Z LL PRIOR TO WORK CHANNELIZATION DEVICE SPACING (feet) MPH TAPER TANGENT 50 / 70 40 80 NOTE: 35/45 30 60 RE S U B MON. - FRI. = 7:00am TO 4:00pm 25 / 30 20 40 NOV 20 2024 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT ATCO COMMUNICATIONS SERVICES, LLC AS THE DESIGNER OF THIS TRAFFIC CONTROL PLAN, MAKES NO REPRESENTATION AS TO ITS GENERAL ADEQUACY OR BEING APPROVED FOR IMPLEMENTATION. MINIMUM SHOULDER TAPER LENGTH = L/3 (feet) SHOULDER POSTED SPEED (MPH) WIDTH (feet) 25 30 35 40 45 50 55 60 65 8 40 40 60 90 120 130 150 160 170 190 10 40 60 90 90 150 170 190 220 220 240 SIGN SPACING = X (1) FREEWAY &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 25 / 30 MPH RESIDENTIAL &BUSINESS DISTRICTS 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 NO: 2 OF 3 SYMBOL LEGEND: OS SIGNALIZED INTERSECTION SIGN LEGEND: PHASE OCONE (CANDLESTICK) ji ® TYPE III BARRICADE IlAlli ROAD SHOULDER ATCO COMPAUNICATIONSSERVICES, LLC WORK TRUCK WORK WORK www.atcatelecom.corn AHEAD 360.563.9000 WORK ZONE LIMITS 708 First Street PORTABLE SIGN W20-1 W21-5 Snohomish, WA 98290 Q EXISTING SIGN e y ® DRIVEWAY zIPI f i be t ARROW BOARD (WHERE REQUIRED) Everett, WA98206 DIRECTION OF TRAFFIC �•+" (NOT PAVEMENT MARKINGS) R8-3a 11 FLAGGER-SPOTTER O w00 3 11 7411 m N Q 4 FLAGGER STATION i z 04 j a 0 o oN U.1 Q J o WORK DETAILS: 40 1 � � w I r ' I N DOWN STREAM I 40' � 0- cn TAPER SHOULDER TAPER O J W FROM FP ON LEFT OF ADDRESS 7411 THEN HAND DIGGING I X X 0 O LU 64 FT TO LEFT OF HOUSE 7411 241 ST ST SW V 241st STREET SW � b W21-5 wz0 1 � w m 25 MPH `" 00 w= 7 Q 2 241 st STREET CONTRACTOR TO PLACE NO PARKING SIGNS ON BOTH CD N 7 F SIDES OF THE STREET 72 HOURS PRIOR TO START co 25 MPH L WORK (.0 ® O W20-1 < SPOTTER NEEDED FOR PEDESTRIAN TRAFFIC I I I X AND DRIVEWAY ACCESS. w 7516 > co r , Of 7430 J O z U POT HOLES SHALL BE REQUIRED WHERE BORE 0 PATH CROSSES ANY UNDERGROUND UTILITY ') w 'i LU UJ co m � [If'ji Q m� ¢ z z o Q w co 1-- 1-- 1-- < o o a w of D_ w a- a- z LL CHANNELIZATION DEVICE SPACING (feet) MPH TAPER TANGENT 50 / 70 40 80 NOTE: 35/45 30 60 R E S U B MON. - FRI. = 7:00am TO 4:00pm 25/30 20 40 NOV 20 2024 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT ATCO COMMUNICATIONS SERVICES, LLC AS THE DESIGNER OF THIS TRAFFIC CONTROL PLAN, MAKES NO REPRESENTATION AS TO ITS GENERAL ADEQUACY OR BEING APPROVED FOR IMPLEMENTATION. MINIMUM SHUOLDER TAPER LENGTH = L/3 (feet) SHOULDER POSTED SPEED (MPH) WIDTH (feet) 25 30 35 40 45 50 55 60 65 70 8 40 40 60 90 120 130 150 160 170 190 10 40 60 90 90 150 170 190 220 220 240 USE MINIMUM 3 DEVICES TAPER FOR SHOULDER LESS THAN 8' SIGN SPACING = X (1) FREEWAY &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 25 / 30 MPH RESIDENTIAL &BUSINESS DISTRICTS 200' ± (2) URBAN STREETS 25 MPH OR LESS 100' ± (2) (1) ALL SPACING MAY BE ADJUSTED TO ACCOMMODATE INTERCHANGE RAMPS, (2) THIS SPACE MAY BE REDUCED IN URBAN AREAS TO FIT ROADWAY CONDITIONS. DATE: 11 /20/2024 REVIEWED BY: M. LUNA WTCS# 013184 DESIGNED BY: D.GRAHAM ATCO CONTACT: 559-826-9359 Dorothy.Graham@atcotelecom.com SCALE: SHEET: 1 "=50' 0.� NO: 3 OF 3 RECEIVED J U N 24 2024 CITY OF EDMONDS Right -of -Way Application #1500490 - 181432 MyBuildingPermit. corn CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT Applicant First Name Last Name Company Name Arrianne Mommsen Ziply Fiber Northwest LLC Number Street Apartment or Suite Number E-mail Address 426 E Casino Road grpatcopermits@ziply.com City State Zip Phone Number Extension Everett WA 98208 (402) 670-8384 Contractor Company Name PACIFIC CABLE CONSTRUCTION INC Number Street Apartment or Suite Number PO Box 573 City State Zip Phone Number Extension Woodinville WA 98072 (425) 348-7735 (206) 730-5945 State License Number License Expiration Date UBI # E-mail Address PACIFCC954PJ 10/21/2025 FDD5877Dq caitlin.reid@ziply.com Project Location Number Street Floor Number Suite or Room Number 7411 241 ST ST SW City Zip Code County Parcel Number EDMONDS 98026 00488800601002 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 DAVIS JARED & SMITH COURTNEY Number Street Apartment or Suite Number 7411 241 ST ST SW City State Zip EDMONDS WA 98026 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: 6/22/2024 Submitted By: Arrianne Mommsen Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Right -of -Way Application #1500490 - 181432 Project Contact Company Name: Ziply Fiber Northwest LLC Name: Arrianne Mommsen Email: grpatcopermits@ziply.com Address: 426 E Casino Road Phone #: (402) 670-8384 Everett WA 98208 Project Type Activity Type Scope of Work Utility Purveyor Utility Work Disturbance of Surface Project Name: 181432 Description of DOR / Hand Dig or Other from pole across street on right of address 7430 and on left of Work: driveway 7541 and 7450, pulling from pole across driveway to FP DOR across street to FP at address 7411 then hand digging to left of house. Project Details Project Information Job Number 181432 Page 2 of 2