100029373 - City of Edmonds Permit.pdfof EM10��3
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ROW PERMIT NO.: ENG
ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME:
CONTRACTOR:
Mailing Address: Co.
State License #:
City Business License #:
CONTACT: ;
Phone #: L - 7 S 3 ® r 15-
Fax #:
Email #: �-'J O A. ' o —
❑ Liability Insurance El Bonded
2 1 oo o 7o44
ADDRESS OR INTERSECTION OF CONSTRUCTION: Z-% o 10 7,1
ROW WORK ASSOCIATED WITH THE FOLLOWING TYER OF PROJECT:
Commercial Subdivision El City Project Traffic Control (Only)
❑ Multi -Family ❑ Single Family ❑ Other
❑ EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit? ❑ Yes ❑ No
ANY ASSOCIATED PERMITS? BLD# ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) :,o
fie.. ��,..� � �„��. �..•�.. �" . �'� �. �,
,p p j 1 %
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YESD NO LJ Year:
PAVEMENT CUT: ❑ Yes ❑ No If yes, indicate size of cut: x
CONCRETE CUT: ❑ Yes ❑ No If yes, indicate size of cut: x
RIGHT-OF-WAY
DURATION
AREA
TOTAL
CLOSURE
(NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF
X
LF
SF
Alley 72 Hrs + LF
X
LF
SF
`,�
Parking 72 Hrs + LF
X
LF
SF
APPLICANT TO READ AND SIGN
*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 is to 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.
Indemnity., The Applicant has signed an application which states he/she hold 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 defense costs and attorney fees by reason
of granting this permit.
I have read the above statements and understand the permit requirements and acknowledge that I must
follow all requirements in ord for-diepeit to be valid.
SIGNATURE ,. 3 - -- DATE
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
REQUIREMENTS FOR
WORK HOURS VARIANCE
PERMITTING & DEVELOPMENT
BUILDING DIVISitON
121 5th Avenue N
P: 425,771,0220
www.edmondswa,gov
The Code:
Based on ECC 5.30110 Sounds exempt during daytime hours;
Section B. Sounds originating from temporary construction sites as a result of construction activity are exempt from the provisions of
this chapter, but only during the hours of 7:00 a.m. to 6:00 p,m, on weekdays and 10:00 a.m. to 6:00 p.m, on Saturdays, excluding
Sundays and federal holidays_
5,30,120 Variances.
A. Variances may be granted to any person from any requirement of ECC 5.30,040 (maximum permissible sound levels) or 5.30.110
if findings are made that immediate compliance with such requirement cannot be achieved because of special circumstances
rendering immediate compliance unreasonable in light of economic or physical factors, encroachment upon an existing noise
source or because of non -availability of feasible technology or control methods.
B. Any such variance or renewal thereof shall be granted only for the minimum time period found to be necessary under the facts and
circumstances.
C. Variances shall be processed as a Type 1 permit procedure under ECDC 20.01.003.B, while using the criteria found in subsection
A of this section. Factors to be balanced in the process include those identified as follows:
1. Public convenience —Will the work result in significant delays for transportation, services, or other customer needs if done only
during the day and within the hour restrictions set out in other parts of this chapter?
2. Public Safety — Does working outside of normally allowed significantly improve safety conditions for the traveling public and/or
construction workers?
3. Public exposure — What will be the setting for any proposed work outside of regular hours? Is it located on an arterial street or in
a mostly residential area?
4. Public cost — Does a limited amount of authorized outside of regular hours established by this chapter save the public
significant cost compared to daytime work?
5. Noise reduction measures -- Have all reasonable steps been taken to reduce the impact of any necessary noise outside the
standard hours? Answering this question needs to include evaluation of (1) limiting the nighttime or early morning work to only
that necessary to reasonably mitigate the issues identified above, (2) use of quiet generators and quiet pumps (as available),
(3) drilling and placing of piles instead of driving them, as well as use of other techniques, design choices, and acoustic control
equipment and strategies necessary to minimize the night-time or early morning impacts from construction noise.
0. The grant of a variance shall not relieve any person from the requirements of ECG 5.30.130 relating to public disturbance noises.
A Temporary Construction Site is defined as the location of a development -related construction project being performed under a
City -issued permit, where required.
Procedures:
For Private Development -related Projects, applications for a noise variance shall be submitted to the Development Services
Department no latert.han 2 weeks prior to the requested activity, or as otherwise deemed appropriate. by the director. An earlier date.is
strongly recommended because approval could take longer if necessary if information is unclear or missing or the.department needs
additional. time to consider relevant factors. Applications must be accompanied by documentation and rationale sufficient to identify the
dates) and time for which the variance is being requested and to demonstrate compliance with the criteria set forth in the ordinance.
The director or designee shall render a determination based on the authority under ECC 5,30.120, Approval or denial shall be in writing.
Fees:
The fee amount shall be that as established in the current department fee schedule for a Type 1 Staff Decision (currently $285 which
includes a technology fee) and is payable upon application. Refunds will not be available once a determination has been made,
whether approval or denial.
FORM S V:\DESKTOP\Work Hours Variance Form B 2017,docx Updated: 09/25/2017
n� L t>,y�
DEVELOPM ENT SERVICES
WORK HOURS VARIANCE REQUEST FORM
121 5th Avenue N, Edmonds; WA 98020
Phone 425.771.0220 k Fax.425.771.0221
Sr
PROJECT NAME:
PERMITS) #:
PROJECT ADDRESS:
2-v o 10 �? 0'Vk t
APPLICANT: {_
k,
Phone:
� 0/4'. -d
Address (Street, City, State, Zip):
F �) : 6-o,, 110-7
E-Mail:
Lt ars
PROP RTY OWNER:
Phone: l
f�
Address (Street, City, State, Zip):
E-mail:
CONTACT PERSON: (This person must be available at all times that
Phone:
extended work is being performed) jj
Address (Street, City, State, Zip):
E-Mail:.
CONTRACTOR:
Phone:
Address (Street, City, State, Zip):
E-Mail:
DATES AND TIME OF EXTENDED WORKTIME REQUESTED: w
s���
WA State Contractor License #/Exp. Date:
f &bj
City of Edmonds Business License #/Exp. Date:
5/0
DETAILj{gTjH{E SCOPE OF TO� BE PERFORMED DURING THE REQUESTED
gjWORK gTIMES: - y )qj yy
v Vt Xa o-t C, c -A 3J V �"�' �+�N
i.
y G°.+na...l"o , an/i9C�y �9.i1�- i/� i i-..r'y{-�. .�''-i. •f'�.3'�"4�� C.Y��+
--+3
S,R. f`.a9 = .m Cr. £>, G T ° At�..(�,,�
Q ' A RATIONALE FOR THE PROPOSAL SHALL BE suamirrED INADDITION TO THIS FORM, PLEASE REFER TO THE WORK
HOURS VARIANCE REQUEST HANDOUir WHICH ASKS FORAN EXPLANATION OF HOW THE ACTIVITIES WILL COMPLY WITH
THE REQUIREMENTS OF THE VARIANCE ORDINANCE.
Print Name. ,r
Signature: y,_:..__„_ Date: Zz
FORM B V:IDESKTOMWork Hours Variance Form B 20I7,docx Updated: 09/25/2017
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PUBLIC UTILITY 0lSfRlg_M0 tj
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PROJECT COMCAST 235599
- — —
--- — --------------------------------
LOCATION 21000 70-1-H AVE W, EDNAONDS
ENGINEER MICHAEL LAUER
DATE 4/25/2018_ ORDER 100029373
PHONE 425-783-5154
CELLULAR 425-239-0858
LANE CLOSURE ON A TWO --LANE ROAD
(TNAIO FLAGGER OPERATION)
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I SNOHOMISH CO
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PROJECT COMCAST 235599
LOCATION 21010 70TH AVE W, EUVONDS
ENGINEER MICHAEL LAVER DATE 4/25/2018_ ORDER 100029373
PHONE 425-783-5154
CELLULAR 425-239-0858
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235599
PUBLIC UTILITY
ZISTR[CT :NO.1 OF SNOHOMISH COUNTY
LOCATION 210.10 70TH.`
AVE W, EDMONDS
L1`NNWOODAREA
POLE N0. �ti _-----...
_ - 'i;1/45 ; ._.__T..dt'i7 -R-4----
DATE ----4 / 5_1 2_�.��c�
ORDER j�s3 Q2. a323...
REASON FOR WORK MAKE
READY WORD, SO COMCAST'
ENGINEER MIRLA, ER
OPERATION 00. 0
------ - ---- -- CAN
AT-T-ACCH TO 6 PUD POLE _
DRAFTER MRI_
U.G. N0. N / A
SCALEyT8
APPROVED
& ----
------------ --
DATE PRINTED
DATE WORK COMPLETED
FOREMAN
FEES REQ'D N YES ONO
RIMARY OVERHEAD
RESIDENTIAL
0 OMMERCIAL
LE N0.
ENG AS -BUILT VERIFICATION DATE
❑ PHASING, TAPS & FUSING --'--" -_---- ----
❑ POLE & VAULT STENCILS SUBSTATION ....................
❑ CABLE TAGS I CIRCUIT NO._.6.p,,_._...__..._.... PHASE J.?,
❑ FRAMING
❑ EQUIPMENT LOCATION
VERIFIED BY
'Las _S DATE
SECO DARY OVERHEAD NESC VIOLATIONS
BASIC FEE S ❑ NO ■ YES (SEE NOTES)
@S =S PERMITS (DATE GRANTED)
METER/C V. POLE S ❑ TREE TRIM
PRIMARY U DERGROUND ❑ STATE
❑ RESIDENTIAL ❑ COUNTY
❑ COMMERCIAL M CITY _ - -- -- --
SIC FEE S ❑
AEU NO.-_._........_.._.____- ------ EASEMENTS
❑ REQUIRED ■ NOT REQUIRED
SECONDARY UNDE ROUND
BASIC EE s
@$ _
DATE RELEASED
UNDERGROUND —PLAT
FOREIGN CONTACTS
■ JPN#
BASIC FEE
FT.PB '_
`"
❑ JOINT TRENCH FRONTIER & CATV
_-_--___._�..-.... _......__._.._...._.._.
❑JOINT BORE FRONTIER &CATV
STREET LIGHTING
❑
_ q FT.9$ _ '=g
_ __
POLE STENCILING
WORK IN RIGHT OF WAY
FROM TO
EI PRIMARY
---------------- •--------------
TAKE OFF POLE
- -
❑ SECONDARY
PRE—CONST. REQUIRMENTS
❑TREE TRIM ❑PUD LOCATOR
FT.@$ _'=S _
MISCELLANEOUS FEES
❑ BACKHOE 0 FLAGGING
VAULT S__
0 ONE CALL DATE '
PERMIT S.._.......... _
No. --�--
T k4 OU /rf- - S_ %-9 0.
STREET LIGHTING
S
■ YES ❑ NO
-------_.. —
M&R
AS -BUILT
S
GIs
TOTAL DC_}_EI"8
DATE PAID
GIS QC
M&R
GIS Ph
JOINT USE
RECEIPT NO.
LOCATION MAP PAGE 455 86
SERVICE ORDER NO.10000065218
was'Ll te-I
0 EXISTING POLE
0 EXISTING POLE —TO BE REMOVED
• NEW POLE
)10 NEW POLE TO REPLACE EXISTING OLE
ENGR'S TEL. #
45- 73�515
ENGR'S CELL #
t25-•:39-0i�
-- MAKE READY WORK -- 100029373
SHEET 1 OF 2
CONS-FRUCTION DETAILS
PL1206088,
(D PL.1 188204.
EXISTING
VINT USE VIOLATIONS
- PUD MIAINTENANCE REOUIRED
EXISTING NESC & JOR�T USE VIOLATIONS - TALLER POLE RE01ARED
COMCAST
D WAVE FRAMED IN FRONTIER SPACE
MID SfPAN C1 EARANCE VIOLATION IN. SPAN SOUTH OF POLE
PUD TO GROUND STLT
WAVE FRAML15 IN FRONTIER SPACE
PUD TO DRESS SECONDARY DRIP
LOOPS TIGHT TO NEUTRAL
PUD TO WORK AFTER NORMABUSINESS HOURS
OT RE DUE TO C0MM;ERC]k% CUSTOMER OUTAGES, SEE NOTES
t ILS!
COMCAST
TO RAISE ATTACHMENT
TO 26'AGL
y PUD TO REPLACE 45'Cl-2 POLE &
WAVE: TO
RAISE ATTACHMENT TO
255AGL
SET NEW 50'CL.' POLE, PW1050, W/ (�ROUND PLATE, N0110, TIGFIT NORTH
COMCAST
TO THEN OVERLASFI
- FRfiJK OH PRIM PER ASSY 12F306, 10'3 PH FL,AT TANG, W1 NEUTf' AL. 8� BEli-OW PRIM
- FRAME UG PRIM PER ASSY 12U308, 3 PH UG TERNI '100A CUTOUTS' FUSED AT 40A, E1040
- REMOVE 3' OF (3) 1/0 AL TRXLF) JKT CNC NEUT, C0902,
IN 4" PVC FROM POLE TO A4�5063, CP-,,rB,LES 6-4674, 6,44-10,575, & 64-676
PLA 101178.
TRANSFER 4" UG PRIMARY RISER & EXTEND PAST NEUTRAL
RUN 78'OF (3) 1/0 Al- TRXLP JKT CNC NEUT, C0902, IN 4" PVC FROM POLE TO
EXISTING
N'E"SC &, JOIN"I" USE VIOLATIONS - PUD MAINTENANCE REQUIRED
A-4-5063, PER INC LUDE UGNO 57- 1282, CABLES XXXXX, XXX. XX& XXXXX
'MAST,
MID. -SPAN
CLEARANCE' VIOLATION
IN SPAN SOUTH OF POLE
- INSTALL 6'STLT 3:.0501, 36" BELOW NEUTRAL. 6, TRANSFER SL-130071-A
COMCASf
& WAVil" I RAMED IN FRONTIER SPACE
PUD To GROUND STL.T &., COVER
LEADS W/ PROTECTIVE MOLDING
IF NEEDED RE PLACT W/ 50W 2M LED 1:-UM,L0210,Si---...-,.--.-,--.-,,-,-..,--A
PUD TO REMOVE EXCESS SLACK
IN SPAN SOUTH OF POLE
- GROUND STL.T MAST 8? COVER LEADS W/ PROTf-CTIVE MOLDING
-
PUD TO DRESS SECONDARY DRIP
LOOPS TIGHT TO NEUTRAL
- INSTALL (4) SERVICE T/0 INSULATORS, 10111, ON DOUBLE NEUTRAL SPOOL
& TRANSFER (6) OH SERVICES
"
DRESS SECONDARY DRIP LOOPS TIGHT TO NEUTRAL
C,Qi�,CAST
-1-0 RAISE AT
TO 26'AGL
- STENCIL NEW POLE ECD--2
- WAVE _T1'O
RAISE` ATTACHMENT TO
25.5'AGL
- STRIP & TOP OLD POLE TO BE REMOVED AFTER COMMS TRANSFER
- COMCAST
TO THEN OVERLASH
I=OES
PLI 10177.
- 12 HOURS OT PRE -APPROVED
COMCAST TO TRANSFER
- ATTACHIVIENT Al 2`6' AG1.
- WAVE TO TRANSFER ATTACI-IMENT AT 25.5*ACL,
EXISTING
NESC VIOLATION - PUD
MAINTENANCE REOUIRED
- FRONTIER TO TRANSFER AT 24.5AGL AN01 BELOW
C OMCAST
;I
FRAMED W/IN 40" OF SECONDARY DRIP LOOPS
- COMCAST TO THEN OVERLAPSH
PUD TO DRESS SECONDARY DRIP
LOOPS TIGHT TO NEUTRAL
QJj1AG',E_D E-TALL
COMCAST
TO THEN OVE-IRLASH
TC SPAN AMERICA
CLOSED FROM 5PM TO 6AM
PL1188202-
TERRANCE CONWAY
4-25-,774-2718 - 48 HOUR NOTICE
- EXISTING
JOINT USE VIOLATION PUD MAINTENANCE REQUIRED
THE WHOLE PUP
- COMCAST
e-- WAVE FRAMED IN FRONTIER SPACE
CLOSED FROM 7PM TO 6AM
PUD TO GROUND STLT & COVER
LEADS W/ PROTECTIVE MOLDING
DOUG HOWELL
PUD 'TO DRESS 'SECONDARY DRIP
LOOPS TIGHT TO NEUTRAL
425--218-1500 - 48 HOUR NOTICE
- COMCAST
TO RAISE ATTACHMENT
TO 26'AGL
- WAVE TO
RAISE ATTACHMENT TO
25.5'AGL
- COMCAST
TO THEN OVERLASH
r j--d H 71�.
[pDaD=
T'FZFffiJTILITY DISTRICT 1d0 Ij
ORDER I OPERATION I SCALE
COMCAST 235599 -
DFTR ENGR _TAPVD_/DATE
MRL I MRLAUER
MAKE READY WORK
DATE
4/25/2018
SHEET 2 OF 2
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