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ENG20170037.pdf
' CITY OF EDMONDS C/O Susan att: Sidick C/O Susan att: Sidick 1660 Park Lane 121 5THAVENUENORTH-'EDMONDS, WA 98 020 6�a1$ 9 PHONE: (425) -'FAX: (425) 771-0221 *PERMIT 'MUST BE POSTED ON JOBSTE* STATUS: ISSUED ENG20170037 RIGHT OF WAY PERMIT (,;-City PrOject) Permit Number: ENG20170037 Expiration Date: 09/07/2017 Job Address: 121 5TH AVE N, EDMONDS Location: 7600 212TH ST SW JxPPEtc-'x PSF/In fras ource CONTRACTOR P SE/I nfraso urce " C/O Susan att: Sidick C/O Susan att: Sidick 1660 Park Lane 1660 Park Lane Burlington, WA 98233 Burlington, WA 98233 (425)457-6353 LICENSE 4: infrasl871 e2 EXP: 02/22/2017 *For City Project 212thSt SW &76th Ave W* Relocate 2 sections of 6" STW IP gas main to drainage conflicts with 212th ST SW & 76th Ave W Intersection Improvement Project- (PM Bertrand Hauss) 2-2x20 asphalt concrete cuts ,SSESSED VALUE: $0;00 PROPERTY AREA: ,0 IDEWA'LK: ( OXO) DURATION IN MONTHS: 0 FEE: $0,,00 STREET DISRUPTION TRENCH CUT: ( 2 X 20 ) ARKING: ( OXO) DURATION IN MONTHS: 0 FEE: $0,00 YEAR OF OVERLAY: 0 FEE: $0,,00 I FV l nyO 1 TITTRATIlIN IN. AA(INT.NS A FFF. -w r)() INDEMNITY The Applicant has signed an application Ivhich states he/she holds the City of Edmonds harmless from injuries, damages or claims ;ofany'kind or description whatsoever, foreseen, or unforeseen, that may be made against the City ofEdmonds or any ofits:departments or employees, includingbut not limited to the defense ofany legal proceedings including, defense costs and attorneyfees by reason ofgranting this permit. THECONTRACTOR IS RESPONSIBLEFOR WORKMANSHIP AND MATERIALS FOR A PERIOD OFONEYEAR FOLLOWING THEFINAL INSPECTION AND ACCEPTANCE OFTHENVORK • 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 DIAL,A-DIG (1-800-424-5555) BEFORE ANY EXCAVATION CALL FOR INSPECTION (425) 771-0220 EXT. 1326 24 HOUR NOTICE REQUIRED FOR ALL INSPECTION REQUESTS THIS APPLICATTON IS NOT PERMITUNTIL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN SPACE PROVIDED, Printed: Tuesd9j,`March 07 201' Cil .iuL 3 � /% ❑ FILE COPY F� INS PECTOR COPY F� APPLICANT COPY STATUS: ISSUED ENG20170037 • Restore ROW to City standards • Restore Landscape to like or better conditions. w 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, • Call for required insPections as noted. Traffic Control per approved plan and MUTCD. Refer to City of Edmonds traffic control requirements. • 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 7:00amto 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays, excluding Sundays and Federal Holidays. At all other times the noise originating from constructionsites/activities must comply with the noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120. • Work hours: 8am-Ipm & 2:30prn-6pm, Monday -Friday. • 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 fiom any and all claims for damages of whatever nature, arising directly or indirectly fi•omthe issuance ofthis 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 -Traffic Control • E -Engineering Final PARTIAL INSPECTION DATE: INITIAL:NOTES: PARTIAL INSPECTION DATE:. ........ .......- INITIAL. ... NOTES: �WWWmWW FINAL INSPECTION APPROVED DATE:µ - INITIAL: . Seo JAN 2 7 2016 jy�?y 4� 4 w uW 1� IV.t_tPMLNTLkVICI ROW PERMIT NO.: ENG ISSUE DATE: RIGHT-OF-WAY CONSTRUCTION PERMIT APPLICATION PROJECT NAME: 109098145 CONTRACTOR: PSE/Infrasource Mailing Address: 1660 Park Lane, Burlington, WA 96233 State License #: INFRASL871C2 City Business License #: NR -019840 CONTACT: Sue Sidick Phone #: 425-457-6353 Fax #: Email #: Susan.Sidick@pse.com Liability Insurance ❑T Bonded ADDRESS OR INTERSECTION OF CONSTRUCTION: 212th ST SW & 76th Ave W.,, �g"....mm .� ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT: Commercial El Subdivision City Project 0 Traffic Control (Only) ❑ Multi -Family ❑X Single Family ❑ EUC (PUD, VERIZON, PSE, COMCAST, OVWSD): Is this permit part of a blanket permit? ❑ Other ❑ Yes © No ANY ASSOCIATED PERMITS? I BLD# __ITIT ENG# DESCRIPTION OF PROPOSED WORD (Be Specific) : f elocate•three sections of 6" STW It' Gas main and—,, Hone-section.of4"-'•• •-gas..m,iakt-due to drainage conflicts with 212th ST SW 7 76th Ave W Intersection '7 - improvement Project ( PM Bertrand Hauss),.4= 2x20 asphalt/ concrete cuts WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES NO Year: 10961 ❑ Yes, • 2 20 PAVEMENT CUT: ®Yes No If es indicate size of cut: x� CONCRETE CUT: ❑ Yes ❑ No If yes, indicate size of cut: x_ RIGHT-OF-WAY 71 DURATION CLOSURE AREA TOTAL (NUMBER OF MONTHS) Sidewalk 48 Hrs + LF X L 11 F SF Alley 72 Hrs +-..- LF X LF SF Parking 72H rs + - 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 order for the permit to be valid. $My'h@yvnly.r+od bp6 atlµbMk Susan Sidick °xr °°° °°��.5,�°� 01/27/2017 SIGNATURE �FxaxP DATE Contractor or Agent NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE 76th Ave W 4, < ib END 24 1"--S CLI CL < L-OZM ----------------- -------------------------- - ------------- ---- - - - - - .- ... . .... .... .. 1. .- - .... .." .... 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