ENG20130076.PDFIIII�IIII
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CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
R90
PHONE: (425) 771-0220 - FAX: (425) 771-0221
C. 1
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20130076
RIGHT OF WAY PERMIT (7-EUC Standard)
Permit Number: ENG20130076 Expiration Date: 04/26/2013
Job Address: 15625 75TH PL W, EDMONDS Location:
APPLICANT CONTRACTOR
COMCAST OF WA, LLC NCI
1525 75TH AVE SW 1525 - 75th St. SW, Ste 200
Attn: Betty
EVERETT, WA 98203 '
(253)245-0771
LICENSE #, EXP:
DESCRIPTION
The crew will be pushing coax in 2" conduit (conduit was placed by Sno PUD) from pole to pole, the crew will then splice the new
coax in. The crew will then wreck out the existing aerial. 1 expect this work to take no longer than 3 hours. No cuts.
ASSESSED VALUE: $0.00 PROPERTY AREA: 0
SIDEWALK: (OXO) DURATION IN MONTHS: 0 FEE: $0.00 STREET DISRUPTION TRENCH CUT: (OXO)
PARKING: (OXO) DURATION IN MONTHS. 0 FEE: $0.00 YEAR OF OVERLAY. 0 FEE: $0.00
ALLEY: (OXO) DURATION IN MONTHS: 0 FEE: $0.00
INDEMNITY. 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 grunting 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.
• 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
possesion.
• 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.
• Three sets of construction drawings of proposed work are required with the permit application.
CALL DIALrA-DIG (1-800-424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT. 1326
24 HOUR NOTICE REQUIRED FOR ALL INSPECTION REQUESTS
3INEER OR HISMER DEPUTY: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN
SPACE PROVIDED.
Printed: Monday. February 25. 2013
E COPY INSPECTOR COPY APPLICANT COPY
STATUS: ISSUED
ENG20130O76
• Restore ROW to City standards
• Restore Landscape to like or better conditions.
• Call for locates of underground utilities prior to any excavation.
• Alert affected residents and/or businesses prior to work start.
• Conform to approved working drawings and Traffic Control plan.
• Public utilities maintain 5' separation from City Utilities.
• Verify clear bore crossings
• Utility patch restoration to be in accordance with Edmonds Standard detail E2.3
• Maintain erosion & sedimentation control. Keep street clean.
• Construction hours are Monday -Friday 7am-6pm and Saturdays 10am-6pm. No work on Sundays or Federal Holidays.
• Call for required inspections as noted.
• Applicant shall repair/replace all damage to utilities or frontage improvements in City right-of-way per City standards that is
caused by or occurs during the permitted project.
• Sound/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 weekdays and 10:00am and 6:OOpm on Saturdays,
excluding Sundays and Federal Holidays. At all other times the noise originating from construction sites/activities must
comply with the noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120.
• 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 issuance fo this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirements of any City ordinance not limit in any way the City's ability to enforce any
ordinance provision.
• E-Engineering Final
PARTIAL INSPECTION DATE: INITIAL: NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: INITIAL:
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ROW PERMIT NO.: ENG OD 7�>
ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: KL? C e 2A Y V U P CONTACT: M_ aWA'd I_ L ,170 ss
CONTRACTOR: A �, C7 .f,0AST Phone #: .?S 3 . a lx -. p ,�
Mailing Address: Fax #:
/Si?S' i.S'T� STJ�✓ 3U d?ao CVc�E7r�WA 98�oJ
State License #: Email #:
City Business License #: All? —D/KD 7 y ® Liability Insurance ® Bonded
700 *76t7$�
ADDRESS OR INTERSECTION OF CONSTRUCTION: j f&� �� �� P� C= DMONDf� �uA
LROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
❑ Commercial ❑ Subdivision ❑ City Project Traffic Control (Only)
❑ Multi -Family ❑ Single Family
N EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit?
❑ Other
❑ Yes ❑ No
ANY ASSOCIATED PERMITS? BLD# ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) : '77Yc LR6L�l WsLL gg-7 Pugrlru,S
Coq�( --CAI CONyD u_1 7462 Ta
Fy 1 E ?f% Lrfe&, W_-Z4 TYe,-' J&Xc-C Tf/c HEM✓ C0 4 x rN . 77lt CeX i✓
W? �c THEN cVi7cF'K o u T 7f/tF c x Pc C ;r 77-/.rr Gwn,&-
To" T,fXle .vo ZekAJ 2 -IAO1 311?U,
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES ❑ NO ❑ Year:
PAVEMENT CUT: ❑ Yes 0 No If yes, indicate size of cut:
CONCRETE CUT: ❑ Yes '® No If yes, indicate size of cut:
x
x
f
RIGHT-OF-WAY
AREA
CLOSURE
TOTAL
DURATION
(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 orderfpr e Demit to be valid.
SIGNATURE DATE n2 - 2a - ;? o /3
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE