ENG2024-0335+City_Application+7.2.2024_9.07.59_AM+4354467E U&I0"11
RIGHT OF WAY CONSTRUCTION
PERMIT APPLICATION
Complete and submit this Application in accordance with the Submittal
^�c, ;.sa° Requirements outlined in Right -of -Way permit Handout E6,,I.
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
Mims M1091
Project Name Subcleff Custom Residence
Site Address or if no site address use Property Address at NW corner of project area: 8908 189th Place SW
Associated Permits: IBLD2024-0235 IPLN BLD2024-0235 IENG BLD2024-0235
Owner
and Entity Holding Franchise (if applicable)
Name of Company Not Applicable Franchise Ordinance No:
Point of Contact
Title
Address
City
State
Zip
Phone
Email
Contractor and Authorized AgenL of Owner (see note below)
Name of company Richard A. Okimoto, Architect
Contractor Contacts During Construction
Primary Name Leif Helleren Construction, Inc.
Agent Name Richard A. Okimoto, Architect
Title General Contractor
Title Project Architect of Record
Mobile (425)770-1970
Address 9924 225th Place SW
Email stevensl043@comcast.net
City Edmonds
I State WA
Zip 98020-5924
Secondary Name
Phone (425)697-0983
Title
Email raoarch@outlook.com
Mobile
City of Edmonds Business License No:
Email
State License No: 10261
16 Contractor verifies it is currently bonded
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 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)
Prqject 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.)
The parcel has always been undeveloped to this date of application. However, the property owner had, in the past, permitted and
had cons ruc e a concrete curb cut an riveway approach ass own on the urvey and ArchitecturalSite Plan, Sheet A --I-.
Also, past construction included installation of (3) water meters in the ROW as shown on the Survey and Site Plan. One water
meter serves 8816 189th Place ; another serves the adjacent o o the west; and the indicated, existing water meter wi serve
4- -pproxin-rat-ly khw the route as indicateul on the Site Plan.
New work in the ROW will include a new utility ties for Storm Drain and for Sanitary Sewer from the underground street locations
o the house following Me approximate routes ass own on the Site Plan.
All new underground utility work proposed in the ROW is also specified on the Civil Engineer's Utility Plan.
RIGHT-OF-WAY
CLOSURE
AREA
TOTAL
DURATION
(Number of Months)
Sidewalk 72 hours +
7.5 LF
x
39 LF
185 SF
???
Alley 72 hours +
LF
x
LF
SF
Parking 72 hours +
IF
x
LF
SF
SECTION B - If you are not a utility company performing work in the City ROW, skip to SECTION C.
Type of Utility Facilities
1. The work in the right of way is on or for the following type of facilities:
❑ telecommunications ❑ cable ❑ power ❑ gas
❑ water ❑ sewer ❑ storm
Details of Work to be Completed
1. Does the utility owner have existing overhead infrastructure in the area of work?
Yes
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 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.?
City of Edmonds ROW construction permit Application --Page 2 of 3 Updated 3/25/2021
If v-es, answer the follo%jig questions rViated to project. arra, i-e. the- actual area m which the
P!�)jevt is. prop,
-ve wire,cables/line.'s, It yes:
6a. Does your project invol ...'s/
How many are exigting? How many are to be addea.
D(.*.s (mr project involve poles? If yM
omanvroarea exisip&�j'
poeeawft
height of the exisling jx)lft?
How rnativ pule ts are to be remoNed?'
Ivey additional iw)les to heplaced?
I lUW Inanv? What is the height of the additio:.�
(w. Are any poles to be modified/ rebuilt /replaced? If yvlll�l
flow rnan0l What is the heiytht of the jAues, after?
De.scribe the modi ficat ion rebuild:
SECTION C
Traffic Control and Public Safety. Traffic control and publicsafety shall be in accordanev %ith 07ity regWabons as
required by the 0", Engineer. ENvn, flagger must he train; M as reqUired by WAC 296, ij -305 and must have
oertification veri-6ring completion of the rftluired training in their possession.
Rextorstkm. Restoration shall be in accordance with City codes di and Standards, All r%tr**t cut trenwork shall be
Patched with asphalt or Crio
ity approwd material pr to the' end of the workday, NO EXCIFY11ONS.
*1
Insurancv. The City may require the owner or contractor to prxmde proof of insuratice acceptahle to the City prior to
any jV.rmjt appra-val.
me , *
IndemmMcation. The Applicant agre". to defend, indemnify, and hold harmless the (11# ity of Edmonds, its officiaN,
officens., employees, and agents against any in)claimsnes, damages, r claims of any kind or des"chption whatsoever.,
foreseen or unforr"tn, including deferuse'coxtsami Atonicy fees, resulting directiv t,-)r ijidirmlly from an), act or
m
f
oLmlon of the ApplicAnt, its s u bmmn tractors, anyone directiv or indirrctly employint bv theni 1, and anyone for whww
acts or omLi1%8k-)ns they may be liable, arising out of, related to, or by ressin"n, of the granting of this permit; anti
specificallv including but not limited to all lose by the, fitilure of the Applicant to fiAly or advNuately perform, in anv
respect, all authonizations or obligations under th"e pennit. 1ese bindemnification rNuirements shall survive the V,
expiration, revocation, or termination of any resulting ivrM)t approval.
-Uc*ptance of terms� condItions, and requirements. Applicant accepts the ternis, Conditions, and
reire.ments stA forth in this Application and agrees they apply to any rosulting permit and shall comply with then i to
the gatisfaction of the City Rnglnocr, Applicant further agrees to Comply with the tend do listed on the -stibillittal
Requirenients-, nth all applicable 6t%N-nrdinanP0q,, int-litsfing but t *1
W1 no limited to F-CF)C Ti to 04.- and with all applivable
requirenients of state and federal law,
Statement of Applicant. I declare under penalty of per)u ry under the laws of the State (if Washington that: I a ni a
licensed and bonded contractor; the informattun proNided herein is correct and complete; and I ain authohzedhy
owner to act on its behalf and have authority to bind the cromer to this application -
Fees. The Applicant ins re-gx-)nsible for, all it feet,
APPLICAM'SIGNATURE
DAXL:
17"
APP1r.jC,1kYr PRMT-D NAME;
A-P P Ll C.A.Vr T ITLE
NO WORK S11-U.J. BRIM 11RIOR TO PERNIrr I&SUANC'E
CitNY of FAInion& ROW conitnuliOn PeTMA Applit-Atinn -- Page,,j of , -"I Updated 31'2,5/2021