10204 EDMONDS WAY.PDFiiiiiiiiiiiiii
10994
10204 EDMONDS
WAY
RIGHT-OF-W
ity of Edmonds
CONSTRUCTION PERMIT
A. Address or Vicinity of Consfm6tion: ) 0o U
B. Type of Work (be specific): 1i �'_ '• 1 ��
�— cJQ C L CSC a n
r
C. Contractor: Y''1 r O Y.i tK
Mailing Address: 1
State License:#:
City Business License #:t
D. Building Permit # (if applicable):`"
A�
E. ❑ Commercial ❑ Subdivision
❑ Multi -Family [ Single Family
1 INSPECTOR:
F. PAVEMENT CUT: [<ES
CONCRETE CUT: ❑ YES
G. ❑ Mail Approved Permit
0
Pernut No• 32Z423
Issue Date: & J/— 0 -
0
� _ l Ul C.<<-r (C37 �-°j q(o
. Contact: ' C Q
Phone: c4Uu - 1--� � G — q a+ l
Liability Insurance: Bond: $ ?
Side Sewer Permit # (if applicable):
,N.
❑ City Project ❑ EUC (PUD, VERIZON, PSE, COMCAST, OVWSD)
❑ Other
❑ NO
❑ NO
® Call for Pickup
G. SIZE OF CUT _ X S
INDEMNITY. Applicant understands by his/her signature to this application 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 Citv 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 ofgranting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH IS
COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
o 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.
o 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.
o Three sets of construction drawings of proposed work are required with the permit application.
CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK
I HAVE READ THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE
THAT I MUST MAKE THE PINK COPY OF THE PERMIT AV AILABLE ON SITE AT ALL TIMES FOR INSPECTIONS
Signature: r'�J K Q S"' �L Date: d — �Q O N�
(Contractor or Agent)
P
CADocuments and Settings\CurtisNy Documents\Forms\Engnrng\ROWpermit_ doc Revised 10/01/03
Pilchuck Contractors, Inc. y�xo
Job # 107024946
Oct 5, 21005
Sheet 1 of 2 Rob Inglis'b°'"�
NOT
TO
SCALE
Notes:
1. All signs and spacing to conform
to the MUTCD and City of Edmonds
Traffic Control specs.
2. Channelizing devices are 28"
traffic cones.
3. All signs are 48" x 48" B/O unless
otherwise specified.
4. Alert affected residents.
5. Work to take place between 9 a.m.
And 4 p.m.
6. Work area will be 22' NW of CA of
102 PI SW & 90' SW of CA of SR 104.
MEDIAN APPROVED Ab NU I EU
1� BY ENGINEERING
QV Chi NERl�G)Ir 'F" ':-OR IS RESPONSIBLE FOP
El`EROS Ol :'aT t y . A,kT) DRAINAGE
a3SOl0 0&
HltlM301S
WORK AREA 3' x 5' •
•
IN SHORT LENGTH • O OF SIDEWALK ALONG
102 PL SW
PEDESTRIANS TO BE •
ASSISTED BY FLAGGER •
• •
CHANNELI7ATION DEVICE SPACING
MPH
TAPER
TANGENT
50/70
40
80
35/45
30
60
25/30
20
40
MEDIAN
4
4wpp
LEGEND
•
28" TRAFFIC CONE
®
WORK AREA
TRAFFIC FLOW
rrFLAGGER
WORK VEHICLE
SIGN LOCATION
Pilchuck Contractors, Inc. ay�Nv
Job # 107024946
Oct 5, 2005
Sheet 2 of 2 Rob Inglis �'`°�°`"�
Notes:
1. All signs and spacing to conform
to the MUTCD and City of Edmonds
Traffic Control specs.
2. Channelizing devices are 28"
traffic cones.
3. All signs are 48" x 48" B/O unless
otherwise specified.
4. Alert affected residents.
5. Work to take place between 9 a.m.
And 4 p.m.
6. Work area will be 22' SE of CA of
102 PI SW & 90' SW of C/L of SR 104.
MEDIAN i'iPPRM:D AS Nu i to
BY ENGINEERING
Date:__-
��' ♦ 5P
QV �O Ct":NER/CONTRr; nR IS RESPONSIBLE FOB?
,•..,.'. r,. �. J; IF
coo �0,
WORK AREA 3' x 5'
IN GRASS AND O
GRAVEL SHOULDER
• o
e
0
CHANNELIZATION DEVICE SPACING
MPH
TAPER
TANGENT
50/70
40
80
35/45
30
60
25/30
20
40
NOT
TO
SCALE
MEDIAN
44ip
LEGEND
•
28" TRAFFIC CONE
®
WORK AREA
TRAFFIC FLOW
mrFLAGGER
WORK VEHICLE
e
SIGN LOCATION
Z BRANCH SADDLE
o 90'W, 22'NCA
r
� p'o
Q f
STANDARD GAS CONSTRUCTION NOTES:
1. FIELD LOCATE ALL UNDERGROUND UTILITIES. EXCAVATOR TO CALL "ONE —CALL" TWO
9.
INSTALL MAIN VALVES OUT OF TRAFFIC WHERE POSSIBLE. VALVE MARKERS SHALL BE
WORKING DAYS PRIOR TO CONSTRUCTION, IN WESTERN WASHINGTON CALL:
INSTALLED AND RECORDED BY THE CONTRACTOR PER PSE GAS OPERATING STANDARD
1-800-424-5555. IN KITTITAS COUNTY CALL: 1-800-553-4344.
2525.2600 FOR ALL HP VALVES IF THE LOCATION IS NOT READILY ACCESSIBLE, AND
2. NOTIFY APPROPRIATE PERMITTING AGENCY PRIOR TO JOB START(SEE PERMIT
FOR ALL VALVES WHERE PERSISTANT SNOWFALL MAY OBSCURE THE VALVE BOX .
REQUIREMENTS).
10.
TO PREVENT ACCIDENTAL OVERPRESSURE OF ADJOINING SYSTEMS, NO TWO MAINS
3. ALL CONSTRUCTION IS TO CONFORM TO PSE GAS OPERATING STANDARDS AND GAS
SHALL BE CONNECTED EXCEPT AS SHOWN ON THIS DESIGN UNLESS APPROVED BY
FIELD PROCEDURES.
APPROPRIATE PSE ENGINEER OR PSE REPRESENTATIVE.
4. ,• EROSION AND SEDIMENT CONTROL SHALL BE PER PSE STANDARD PRACTICE 0150.3200
11.
SYSTEM MAOP DENOTED BY: SYSTEM MAOP = 45 PSIG.
�p4
c<` \
.TECHNIQUES FOR TEMPORARY EROSION AND SEDIMENT CONTROL AND ANY ADDITIONAL
'f
'LOCAL JURISDICTION REQUIREMENTS.
12.
GAUGE AND MONITOR USE OF ALL STOPPERS TO ENSURE ADEQUATE FEED.
5. NOTIFY PROPERTY "'OWNERS ADJACENT TO PROPOSED CONSTRUCTION ACTIVITIES A
13.
RESTORE ALL DRIVEWAYS SUBJECT TO OPEN CUT TO ORIGINAL OR BETTER CONDITION.
ro
MINIMUM OF TWO WORKING DAYS PRIOR TO BEGINNING CONSTRUCTION. DISTRIBUTE
FLYERSALONG WITH LIST OF FREQUENTLY ASKED QUESTIONS AND INFORMATION
14.
PURGE POINTS AND PRESSURE TAPS TO BE INSTALLED PER PSE GAS OPERATING
REGARDING THE PURCHASE OF AN EXCESS FLOW VALVE, IF APPLICABLE.
STANDARDS 2525.3400, AND 2525.1200.
�
5 r
6. ANY CHANGE IN ROUTE, PIPE SIZE/TYPE, TIE—IN METHOD OR ADDITIONAL MAIN
15.
MAINS AND SERVICES SHALL BE TESTED AND .PURGED PER PSE GAS OPERATING
FOOTAGE MUST BE APPROVED BY THE APPROPRIATE PSE ENGINEER OR PSE
REPRESENTATIVE.
STANDARDS 2525.3300 AND 2525.3400.
2b
Q �i`'/ 19b
7. COMPLETE "PIPE CONDITION REPORT" ON ALL METALLIC PSE FACILITIES. CHECK BOX
ON REPORT FOR WIRE BOX (TEST LEAD) INSTALLATION.
16.
IF METALLIC PIPE IS INVOLVED, COORDINATE INSTALLATION WITH CP TECHNICIAN
------------- AT--------------
5CI
8. PIPELINE MARKERS AND WARNING SIGNS SHALL BE INSTALLED AND RECORDED BY THE
17.
NOTE ALL ACTUAL FOOTAGE, LOCATION AND MATERIAL CHANGES ON THE AS —BUILT IN
RED. ') DENOTES FOOTAGE
CONTRACTOR PER PSE GAS OPERATING STANDARD 2525.2500.
( BETWEEN FITTINGS.
L,O.
sr
s o
�ti 2"MPEPOLYVALVE
a /m / (OPEN POSITION) �� \
,ti' goti 90'W, 30'5 CIL
- —PROP. 2" Air=ZP rn,14AIN
/ (CUSTOMER PROVIDE TRENCH)
90'W C/L
PLOT PLAN \.
SCALE: 1 "=50' `
eL O
?y c
END Of MAIN
(2" MPE CAP)
90'W, 310'S CIL
GAS PIPE DIRECT BURY
CUSTOMER PROVIDED TRENCH
NTS
1. IF THE TRENCH BOTTOM CONTAINS ANY SHARP OR UNUSUALLY
ROUGH SURFACES, A MINIMUM OF 3" OF INITIAL BACKFILL MATERIA6
IS REQUIRED TO BED THE PIPE, UNLESS THE CARRIER PIPE IS
ENCASED OR WRAPPED WITH AN APPROVED ROCK SHIELD MATERIAL:
2. INITIAL BACKFILL SHALL BE SAND, NATIVE SOIL, OR SOIL -BASED SELECT
MATERIAL THAT DOES NOT CONTAIN ANY SHARP ROCKS OR ROCKS
LARGER THAN 1/2" DIAMETER. SEE PSE SPECIFICATION 1275.1380,
"SAND BACKFILL FOR GAS PIPE, ELECTRICAL CONDUIT, AND CABLE.
3. A MINIMUM OF 6" OF INITIAL BACKFILL SHALL BE PLACED OVER THE GAS
PIPE. IF THE NATIVE SOIL CONTAINS ROCKS LARGER THAN 6" DIAMETER,
THEN A TOTAL OF 12" OF INITIAL BACKFILL SHALL BE PLACED OVER
THE GAS PIPE.
4. IF THE CARRIER PIPE IS ENCASED, INITIAL BACKFILL IS NOT REQUIRED.
THE BACKFILL MATERIAL SHALL MEET FINAL BACKFILL MATERIAL
REQUIREMENTS. WHERE THE CARTER PIPE ENTERS AND EXITS THE CASING,
THE INITAL BACKFILL AND BEDDING REQUIREMENTS APPLY.
5. FINAL BACKFILL MAY BE SOIL -BASED SELECT MATERIAL OR NATIVE SOIL,
BUT SHALL BE FREE OF CONSTRUCTION DEBRIS AND SHALL NOT CONTAIN
ROCKS LARGER THAN 10" DIAMETER TO PREVENT IMPEDANCE OF
GAS SYSTEM MAINTENANCE.
FITTER (CHECK BOX IF COMPLETE)
Work area left in Clean & Safe condition. ❑
GorrlPlgte all Pipe Tables and Gas Pressure Stamp. ❑
Field changes Red —Lined on as —built. ❑
Material verified and Changes noted on paperwork. ❑
All Valve & Tie—in Locations noted on as —built. ❑
Note beginning of Main, EOM & Line of Main locations. ❑
Show Rope Locations & Cul—de—sac Radius. ❑
Foreman's Signature
Company PILCHUCK DATE
1
REV I BY DESCRIPTION.
DATE
GAS MAIN INSTALLATION/RETIREMENT
Type/Work
Pipe Size
Type
Estimated
Length
Actual
Length
Manufacturer
INSTALL
2"
MPE
60'
PLAT
2"
MPE
280,
GAS MAIN PRESSURE & TESTING
TYPE TEST
PRESSURE
TESTED BY
DATE ON
TIME ON
DATE OFF
TIME OFF
TYPE TEST
PRESSURE
TESTED BY
DATE ON
TIME ON
DATE OFF
TIME OFF
Design Press 60
SYS MAOP 45 PSI&
PROJECT PHASE
NOTIF#
ORDER#
a
O
SAP Superior
Service/Meter
Service/Meter
Service/Meter
Service/Meter
Service/Meter
Service/Meter
Service/Meter
Service/Meter
Retirement
Retirement
X208511470
107024946
X208517072
106161327
X208515062
Contractor. CONSTRUCTION COST CODES:
051-103-4
Project Manager Contact Information:
KIM GRAY
425-290-2678 Cell Phone
kim.gray@pse.com
REV# DATE BY DESCRIPTION
2
t
Vicinity Map
Owner/ Developer Contact Info
MATTGALVIN
423 E PIKE 5TREET
SEA TTIE WA 98122
ATTN: ED CHAPMAN 206-372-1196 office
CALL (800) 424-5555
2 BUSINESS DAYS BEFORE YOU DIG
THIS SKETCH NOT TO BE RELIED UPON FOR EXACT LOCATION OF FACILITIES
REAL ESTATE/EASEMENT PERMIT
CSE EDMONDS
FUNCTION / I CONTACT PHONE I DATE
PROJECT MG KIM GRAY 206-418-4233
ENGR - GAS
DRAWN BY
CHECKED B'
COUNTY EMER SECT GAS WK CTR APPROVED B'
SNOHOMI5H 5 MCN5E& CP TECH.
1/4 SEC OP MAP PLAT MAP
NW 36-27-03 164.062 166.066 MAPPING
JOINT FACILITIES ARRANGEMENTS
UTILITIES _
CONTACT
PHONE#
PUGET
SOUND
ENERGY
DESIGNED BY PILCHUCK CONTRACTORS INC.
MLOCK 206-418-4217 10-03-05
KIM &RAY 206-418-4233 /0 3 05
IM 5NYD 206-418-4220 /D G/
MgLIACCI CORPORA TION
2"
MPE IP MAIN EXTENSION
10204 EDMONDS WAY
EDMONDS, WA 98020
Superior Order:
Drawing Number:
N/A
SCALE: PAGE;
1" = 50' 1 1/1
3
U