APPROVED ENG2024-0363 ROW PERMITRIGHT OF WAY EUC PERMIT
PERMIT NUMBER
City of Edmonds
- N, Edmonds WA 98020 ENG2024-0363
www.edmondswa.govi
Description: PSE-REPLACE GAS LINE WITH PAVEMENT CUTS ISSUED: 01/09/2025
Address: 23726 102ND PL W EDMONDS WA 98020-5766
EXPIRES: 07/08/2025
Permit Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 00405800001200
iiiI 11-1411 a
NAME TYPE NAME ADDRESS PHONE
APPLICANT
SUSAN SIDICK
1660 PARK LANE, BURLINGTON WA 98233
(425)457-6353
CONTACT
PUGET SOUND ENERGY- CORROSION
1660 PARK LANE, BURLINGTON WA 98233
(425)457-6353
DEPARTMENT
CONTRACTOR
PSE/INFRASOURCE
1660 PARK LANE, BURLINGTON WA 98233
(425)466-4771
OWNER AARON & CASTANEDA XOC 23726 102ND PL W, EDMONDS WA 98020-5766
BRODNIAK
FEE ••
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE - PER PERMIT $45.00 $45.00
ENG - INSPECTIONS - 4.1.24 $528.00 $528.00
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: 01/09/2025
Printed: Thursday, January 09, 2025 9:43:12 AM 1 of 2
RIGHT OF WAY EUC PERMIT
PERMIT NU �!B E
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
E-7 TRAFFIC CTRL
X-2 ENGINEERING FINAL**
E-7 RESTOR LIMITS
Printed: Thursday, January 09, 2025 9:43:12 AM 2 of 2
of EpM04O�
/'V.isa°
SECTION A
RIGHT OF WAY CONSTRUCTION
PERMIT APPLICATION
Complete and submit this Application in accordance with the Submittal
Requirements outlined in Right-of-Wgy permit Handout E6�.
RECEIVED
Jul 29 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 10915668o
Site Address or if no site address use Property Address at NW corner of project area: 23726 102 PL W
Associated Permits: BLD PLN ENG X
Owner and Entity Holding Franchise (if applicable)
Name of Company PSE/Infrasource Franchise Ordinance No:
Point of Contact Susan Sid ick
Title SR Permit Specialist
Address 1660 Park lane
city Burlington
State WA
Zip 98233
Phone 425-457-6353
Email susan.sidickapse.com
Contractor and Authorized Agent of Owner
Name of Company
(see note below)
Contractor Contacts During Construction
Primary Name PSE/Infrasource Susan Sidick
Agent Name PSE/Infrasource
Title SR Permit Specialist
Title SR Permit Specialist
Mobile 425-457-6353
Address 1660 Park lane
Email susan.sidick@pse.com
City Burlington
State WA
Zip 98233
Secondary Name
Phone 425-457-6353
Title SR Permit Specialist
Email susan.sidick@pse.com
Mobile
City of Edmonds Business License No:
Email
State License No: INFRASL871 C2
[N Contractor verifies it is currently bonded
d( Contractor verifies it currently has general liability insurance
NOTE: ECDC 18.6o. o2o 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 ix 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 welt
❑ Traffic Control Only (no associated development)
❑ Utility Franchise Work (no associated development)
City of Edmonds ROW construction permit Application --Page 1 of 3 Updated 3/25/2021
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 existing gas service at aprox log' N c/l of 238th ST SW & 17' E to 13' E c/l of 102nd PL W (2l 3x5 paving cuts
RIGHT-OF-WAY
CLOSURE
AREA
TOTAL
DURATION
(Number of Months)
Sidewalk 72 hours +
LF
I x
LF
SF
Alley 72 hours +
LF
Ix
I LF
SF
Parking 72 hours +
LF
Ix
I 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 3xgas
❑ water ❑ sewer ❑ storm
Details of Work to be Completed
1. Does the utility owner have existing overhead infrastructure in the area of work?
Yes
No
x
2. Will any equipment be added underground or above ground (e.. pedestals, vaults, etc.)?
x
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?
x
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 stem?
x
5.
Does the work involve proposed additions to an aboveground utility stem? 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 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?
x
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:
x
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.
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: Susan Sidick DATE: o7/16/24
APPLICANT PRINTED NAME: Susan Sidick
APPLICANT TITLE: SR 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
Puget Sound Energy Gas Pre -Inspect Form
Job #: 109156680
Service Address: 23726 102nd PI W
Date: 7/5/24
City Edmonds
Zip: 98020
Jurisdiction: Edmonds
Customer:
Phone:
ROW Permit:
Customer Email:
Est. Start Date:
PM / Inspector: Kevin Klacsan
Phone: 253-244-0919
Est. Duration:
Site Contact Email:
Phone:
Job Description
Replace existing service 3/4 STW /5/8 PC Twin w/ new 1 1/8 Twin
New Construction:
NO
Construction Method
Hog
RESTORATION LIMITS TO BE DETERMINED
Building Foundation Type
BY CITY ENGINEERING INSPECTOR
Slab
Septic System
Yes
PLAT Map: 0.000
I
i
N
3 I
E
0
3
I I
I I
I I
I
I
1 I
I I
I I
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.........; ............................... I
. PL
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I I
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l........
.......................................
PL.... ................:..........:...........:..........:....... .
2' deep S'
-...-..-...-i..-....- = —'— .
OS I
1 1
I 2' deep S.
.......... .................................................................... I
I
12'
I 3'
...........................................
I
..........l...
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1 I
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I50' ROW
1 I
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1
Utility patches shall be combined and full width or half
I
I I
1 ti
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 I
I i
1
centerline of roadway. Where utility patches extend into
both travel lanes then a full width overlay is required.
I I
i
I
238th St SW i
I
1
I
_._....... ...... ...... _._._._._._._._._._._._._._._._._.__._._.L._._._._._._._._._._._._._.
I C/L
I
OWNER/CONTRACTOR IS RESPONSIBLE FOR
EROSION CONTROL AND DRAINAGE
Work Location
Size of Cut
Surface Type
109'
1 n
I of CL
1238thstsw
&
1 17'
1 e
I of CL
1102ndPIW
3 X 5 X 2
GRS
109'
n
of CL
1238thstsw
&
13'
w
I of CL
1102ndPIW
3 X 5 X 2
A
109'
1 n
I of CL
1238th st sw
&
3'
w
I of CL
1102nd PI W
3 X 5 X 2
A
Service Information
Street Information
Job Type
Diameter:
Flaggers #:
0
Arterial:
No
SVC Replacement
EFV:
0
Police #:
0
TCP:
No
Tie -In Fitting
Speed Limit:
0
No Parks #:
0
service Tee
oc:
r
Trolley Lines:
No
Mtr Hoods #:
0
s:
Traffic Signal:
Bus Stop:
No
:
2.5" # 4" #
ADA Ramps #:
0
Route #'s:
RECEIVED
Dec 20 2024
CITY OF EDMONDS
DEVELOPMENT SERVICES
DEPARTMENT
Applicant shall repair/replace all ENGINEERING DIVISION
OWNER/CONTRACTOR RESPONSIBLE FOR LOCATING damage to utilities or frontage APPROVED AS NOTED
ALL ON SITE UTILITIES. RELOCATION/REVISION TO ANY improvements in City right-of-way
UTILITIES MAY REQUIRE A SEPERATE PERMIT. per city standards that is caused or 'I,
occurs during the permitted project. 1,ll W�✓�.41..Hn2 12/30/2024
PLEASE SCHEDULE
WITH DISPATCH
@ 800-343-4049 OPTA
AND PROVIDE A
COPY OF THE APPROVED
TRAFFIC CONTROL PLAN
K&D Services, as the preparer of this traffic
control plan makes no representation as to its'
general adequacy or being approved for implementation.
Approval must result from the Traffic Engineer or
other Public Official having statutory enforcement authority
in the jurisdiction. Utilization and implementation of this
plan shall be a result of that approval.
Ref. MUTCD 2009 6A-01 (10)
Notes:
1. Maintain ped. access to
and through crosswalks
2. Maintain Min. 10' lanes
3. Maintain local access
4. Notify Transit Authority
at least 48 hrs. in advance
of bus stop closure
5. Traffic control plan and all
devices shall comply with
MUTCD, PROWAG & WSDOT
6. DEVICE SPACING
Flag Taper 20'
Signs per WSDOT
Tapers per WSDOT
7. 28" Cones
36" Barrels
48" Signs
24" Paddle
8. Adjust to field conditions
CHANNELIZATION DEVICE
SPACING feet
MPH
TAPER
TANGENT
50/70
40
80
35/45
30
60
25/30
20
40
MINIMUM LANE CLOSURE TAPER LENGTH = L (feet)
LANE
Posted Speed (mph)
WIDTH
(feet)
25
30
35
40
45
50
55
60
65
70
10
105
150
205
270
450
500
550
-
-
-
11
116
165
225
295
495
550
605
660
-
-
12
125
180
245
320
540
600
660
720
780
840
SIGN SPACING = X (1)
FREEWAYS & EXPRESSWAYS 55 / 70 MPH
1500' t
RURAL HIGHWAYS 60 / 65 MPH
800' t
RURAL ROADS 45 / 55 MPH
500' t
RURAL ROADS & URBAN ARTERIALS 35 / 40 MPH
350' t
RURAL ROADS & URBAN ARTERIALS 25 / 30 MPH
RESIDENTAL & BUSINESS DISTRICTS
200' t (2)
URBAN STREETS 25 MPH OR LESS
100' t (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.
PAGE 1 OF 2
SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM
Legend
1 Cone
Flagger
o G20-2a end road work
R7-T39 R7-T39
W3-4 Be Prepared To Stop
W20-1 Road Work Ahead
W20-4 One Lane Road Ahead
W20-7a flagger
0 Work Area
Closure affects resident
driveway.
Property owner permission
required to block driveway.
Notify affected residents of
work times and dates.
END
ROAD WORK
yN, — — — — — — — — — — — — —
i
WORK
AHEAD
0
O
;
END
NE LANE
ROAD
t
ROAD WORK
ZD11
G20-2a
DRIVEWAY
A VM3AIba I
TRAFFIC CONTROL INSPECTION SHALL BE
REQUIRED WHENEVER WORK ZONE IS SET UP
ADDL. NOTES:
PLACE SPOTTER AT ANY OPEN DRIVEWAY OR
ENTRANCE LOCATED WITHIN THE WORK ZONE TO
ASSIST TRAFFIC OUT OF WORK ZONE.
MAINTAIN DRIVEWAY ACCESS, IF UNABLE TO NOTIFY
HOMEOWNERS OF TEMPORARY CLOSURE.
MAINTAIN ACCESS TO CROSSWALK.
PLACE NO PARKS 72 HOURS IN ADVANCE OF WORK
BEING PERFORMED.
� BE
_ A■ _ PREPARED
TO STOP
J 200'+/- J
— — — — — — — — — — — —
ROAD
WORK
AHEAD
200'+/-
0
ry
d
�
y
o
+
ROAD
J6
WORK
<
AHEAD
ENGINEERING DIVISION
APPROVED AS NOTED
,ll/ (,VLJ,,lI,,,,,nz 12/30/2024
VV
NOT TO SCALE
NOTIFY EMS, FIRE
AND POLICE
72 HOURS IN ADVAUCE
N
�1
RECEIVED
Jul 29 2024
CITY OF EDMONDS
DEVELOPMENT SERVICES
DEPARTMENT
CUSTOMER:
QPUGET SOUND ENERGY
CONTACT: TANYA MARTINSON
425-417-0639
LOCATION:
23726 102ND PL W
EDMONDS, WA 98020
DATE: W/O #
07/11/24 11855006
nK & D SERVICES
TRAFFIC MANAGEMENT
DESIGNED BY: WHITNEY PATERNO
OFFICE: 800-343-4049 f l
VIRLLI'4Z5-YZJ-YU66 WSTCS#012693
WATCP@KNDSERVICES.NET EXP.1131125
PLEASE SCHEDULE
WITH DISPATCH
@ 800-343-4049 OP11
AND PROVIDE A
COPY OF THE APPROVED
TRAFFIC CONTROL PLAN
K&D Services, as the preparer of this traffic
control plan makes no representation as to its'
general adequacy or being approved for implementation.
Approval must result from the Traffic Engineer or
other Public Official having statutory enforcement authority
in the jurisdiction. Utilization and implementation of this
plan shall be a result of that approval.
Ref. MUTCD 2009 6A-01 (10)
Notes:
1. Maintain ped. access to
and through crosswalks
2. Maintain Min. 10' lanes
3. Maintain local access
4. Notify Transit Authority
at least 48 hrs. in advance
of bus stop closure
5. Traffic control plan and all
devices shall comply with
MUTCD, PROWAG & WSDOT
6. DEVICE SPACING
Flag Taper 20'
Signs per WSDOT
Tapers per WSDOT
7. 28" Cones
36" Barrels
48" Signs
24" Paddle
8. Adjust to field conditions
CHANNELIZATION DEVICE
SPACING feet
MPH
TAPER
TANGENT
50/70
40
80
35/45
30
60
25/30
20
40
MINIMUM LANE CLOSURE TAPER LENGTH = L (feet)
LANE
Posted Speed (mph)
WIDTH
(feet)
25
30
35
40
45
50
55
60
65
70
10
105
150
205
270
450
500
550
-
11
115
165
225
295
495
550
605
660
-
-
12
125
180
245
320
540
600
660
720
780
640
SIGN SPACING = X (1)
FREEWAYS & EXPRESSWAYS 55 / 70 MPH
1500' t
RURAL HIGHWAYS 60 / 65 MPH
800' t
RURAL ROADS 45 155 MPH
500' t
RURAL ROADS & URBAN ARTERIALS 35 / 40 MPH
350' t
RURAL ROADS & URBAN ARTERIALS 25 / 30 MPH
RESIDENTAL & BUSINESS DISTRICTS
200' 1 (2)
URBAN STREETS 25 MPH OR LESS
100' t (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.
PAGE2OF2
SCHEDULE ALL INSPECTIONS THROUGH MYBUILDINGPERMIT.COM
Legend
1 Cone
7t Flagger
o G20-2a end road work
R7-T39 R7-T39
W3-4 Be Prepared To Stop
O W20-1 Road Work Ahead
W20-4 One Lane Road Ahead
* W20-7a flagger
0 Work Area
END
ROAD WORK
:Zits III 5A 5W
— f — — — — — — — —
4-
AVM3AIba
I
AVM3ARI0
TRAFFIC CONTROL INSPECTION SHALL BE
REQUIRED WHENEVER WORK ZONE IS SET UP
i fl
END
ROAD WORK
G20-2a
Closure affects resident
driveway.
Property owner permission
required to block driveway.
Notify affected residents of
work times and dates.
DRIVEWAY
y{l _ A■ _ PREPARED
I TO STOP
200'+/- 200'+/-
,L to1ri J1 JVV
— — F
END
ROAD WORK
WORK
AHEAD
- �3m
� t%tym
O
tJ
Z
d
y o
C o
ny +
i
ROAD
WORK
AHEAD
NOT TO SCALE
f1OTIFY EMS, FIRE
AfID POLICE
72 HOURS IF4 ADVANCE
N
ADDL. NOTES:
PLACE SPOTTER AT ANY OPEN DRIVEWAY OR
ENTRANCE LOCATED WITHIN THE WORK ZONE TO
ASSIST TRAFFIC OUT OF WORK ZONE.
MAINTAIN DRIVEWAY ACCESS, IF UNABLE TO NOTIFY
HOMEOWNERS OF TEMPORARY CLOSURE.
PLACE NO PARKS 72 HOURS IN ADVANCE OF WORK
BEING PERFORMED.
MAINTAIN ACCESS TO CROSSWALK.
ENGINEERING DIVISION
APPROVED AS NOTED
%11 12/30/2024
VV
RECEIVED
Jul 29 2024
CITY OF EDMONDS
DEVELOPMENT SERVICES
DEPARTMENT
CUSTOMER:
QPUGET SOUND FNERGY
CONTACT: TANYA MARTINSON
425-417-0639
LOCATION:
23726 102ND PL W
EDMONDS, WA 98020
DATE: W/O #
07/11/24 11855006
K & D SERVICES
TRAFFIC MANAGEMENT
DESIGNED BY: WHITNEY PATERNO
OFFICE. 800-343-4049 P%6
DIRECT.•425-923-9086 WSTCS#012693
WATCP@KNDSERVICES.NET EXPA131125
E
RECEIVED
Jul 29 2024
CITY OF EDMONDS ,
DEVELOPMENT SERVICES CITY OF EDMONDS MyBuildingPermit.com
DEPARTMENT
Right -of -Way Application #1518595 - 109156680
Applicant
First Name Last Name Company Name
Susan Sidick Puget Sound Energy- Corrosion Department
Number Street Apartment or Suite Number E-mail Address
1660 Park Lane susan.sidick@pse.com
City State Zip Phone Number Extension
Burlington WA 98233 (425) 457-6353
Contractor
Company Name
PUGET SOUND ENERGY INC
Number Street Apartment or Suite Number
1660 Park Lane
City State Zip Phone Number Extension
Burlington WA 98233 (425) 457-6353
State License Number License Expiration Date UBI # E-mail Address
PUGETSE032J 1 3/20/2026 179n 1 M55 susan.sidick@pse.com
Project Location
Number Street Floor Number Suite or Room Number
23726 102ND PL W
City Zip Code County Parcel Number
EDMONDS 98020 00405800001200
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
Aaron & Castaneda Xochitl L Brodniak
Number Street Apartment or Suite Number
23726 102ND PL W
City State Zip
EDMONDS WA 98020-5766
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: 7/16/2024 Submitted By: Susan Sidick
Page 1 of 2
CITY OF EDMONDS MyBuildingPermit.com
Right -of -Way Application #1518595 - 109156680
Project Contact
Company Name: Puget Sound Energy- Corrosion
Department
Name: Susan Sidick Email: susan.sidick@pse.com
Address: 1660 Park Lane Phone #: (425) 457-6353
Burlington WA 98233
Project Type Activity Type Scope of Work
Utility Purveyor Utility Work Disturbance of Surface
Project Name: 109156680
Description of Work: Replace existing gas service at aprox 109' N c/I of 238th ST SW & 17' E to 13' E c/I of
102nd PL W (2) 3x5 paving cuts anticipated
Project Details
Project Information
Job Number
109156680
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