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ENG20170105-APPROVED PERMIT.pdf„I(.1TY OF EDMONDS 121 5TH AVENUE NORTH - EDMONDS, WA 98020 PHONE: (425) 771-0220- FAX: (425) 771-0221 p c. *PERMIT MUST BE POS"T"ED ON JOBSIT * STATUS: ISSUED ENG20170105 Permit Number: ENG20170105 Expiration Date: 05/31/2017 Job Address: 20304 87TH AVE W, EDMONDS Location: 20304 87TH AVE'W PSF/Infras ource PSE/In frasource GO 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 c2 EXP: 02/22/2019 Work area is approx 420'S c/I of 202nd ST SW & 13'E & 4'W c/I of 87th Ave W. To install gas ,service. 1 3x5 soft surface cut & 1 2x4 asphalt cut anticipated. Work to be completed before City overlay of 87th Ave. W. (Appro)imatestart date 6/1/17). 1INFORMATION ASSESSED VALUE: ”' $0,00 PROPERTY AREA; 0 SIDEWALK: ( OXO) DURATION IN MONTHS: 0 FEE, $0,00 STREET DISRUPTION TRENCH CUT: ( 2 X 4 ) PARKING: ( OXO')' DURATION IN MONTHS: 0 FEE, $0,00 YEAR OF OVERLAY: 0'' FEE: $0,00 ALLEY ( 0X0) 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 made against the City of Edmonds or any ofils departments or employees, including but not limited to the defense ofany legal proceedings including defense costs and attorney fees by reason ofgranting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR PERIOD; OF ONE YEAR FOLLOWING THEFINAL INSPECTION AND ACCEPTANCE OFTHEWORK •' 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 NOTICERF UIRED FOR ALL INSPECTION RI IUESTS THIS APPLICATION IS NOT APERMITUNTIL SIGNED BY THE CITY ENGINEER OR HISMERDEPUTY: AND FEES ARE PAID AND RECEIPT IS ACKNOWLEDGED IN SPACE PROVIDED„ Printed; Friday Ar, rli 21 2011 u)Qq,� V/2,1/2_017' RELEASED BY DNff ❑ FILE COPY ❑ INSPECTOR COPY ❑ APPLICANT COPY G20170105 • Restore ROW to City standards • Restore Landscape to like or better conditions. • Call forlocates ofunderground utilities priorto any excavation. • Alert affected residents and/or businesses prior to work start, • Conform to approved working drawings and Traffic Control plan. • Verify clear bore crossings. City of Edmonds reserves the right to request video footage of public or private utilities within the vicinity of the proposed work for verification ofclear .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 6:00pmon weekdays and 10:00am and 6:00pm 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 ofhis 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 of this pen -nit. Issuance of this permit shall not be deemed to modify, waive 'orreduce any requirements of any, City ordinance not limit in any way the City's ability to enforce any ordinance provision. INSPFiCTIONS • 1rEngineering Final PARTIAL INSPECTION DATE: INITIAL: NOTES: PARTIAL INSPECTION DATE: _ �.�... INITIAL: NOTES: FINAL INSPECTION APPROVED DATE: INITIAL: O� ED ', 1, SCANNED MAR Vi 1117 ROW PERMIT NO.: ENG 201,1 — 01 D ISSUE DATE: -OF-WAY CONSTRUCTION PERMIT A.PPLICATION PROJECT NAME: 106321664 CONTRACTOR: PSE/Infrasource Mailing Address: 1660 Park Lane, Burlington, WA 98233 State License #: INFRASL871 C2 City Business License #: N R-023614 CONTACT: Sue Sidick Phone #: 425-457-6353 Fax #: Email #: Susan.Sidick@pse.com El Liability Insurance ❑ Bonded ADDRESS OR INTERSECTION OF CONSTRUCTION: 20304 87 AVE W ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT: F] Commercial Subdivision 1:1 City Project Traffic Control (Only) ❑ Multi -Family X❑ 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) : Work area is approx 420'S C/1 of 202nd ST SW & 13' E & 4'W c/I of 87th AVE W. To install gas service 1 3x5 soft surface cut & 1 2x4 asphalt cut anticipated. WAS STREET OVERLAYED WITHIN THE LAST FIVE (5) YEARS? YES E] NO n Year: 106 PAVEMENT CUT: ® Yes ❑ No If yes, indicate size of cut: 2 x 4 CONCRETE CUT: 0 Yes ❑ No If yes, indicate size of cut: x RIGHT-OF-WAY DURATION AREA TOTAL CLOSURE (NUMBER OF MONTHS) i 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 order for the permit to be valid. Susan Sidick �,4W V, S�[ 3/27/2017 UN ff.% Woou=strael Use MM eJrw�m, ana�wR nb%Wiyn dw�'n, e..nrybs SIGNATURES r�.�b. DATE Contractor or Agent NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE � rUGE/ SOUND E/n/—»x��(/��y Y Job#100321664 2O30487thAvVVEdmonds, VVA March 24.2U17 Sheet i of stophon.gadka@pao.uom (425)424-6481 202ND ST SW Notes: 1.All signs and spacing hzconform tuthe K8UTCD and City ofEdmonds standards. C5 2.AUsidewalks, ddvowayx.axUoand ogmox000huUba — completely clear unless otherwise indicated. 3.Channo|izingdevices are 28"traffic cones. CD 4.Sign size can baaminimum of48"x48"and shall not obstruct pedestrian access, 5.Crew |arequired toleave aminimum of11'fortraveling � lane width. ` O.Alert affected residents and businesses. 7.Work totake place bobmoonlo.m.and kp.m. 8.Work area will be 13'ECL&4'VVCLof87thAVVV & approximately 42O'SCLof2O2ndStSW. 8.|fused, place NO -PARK signs 72hours inadvance ofthe day that the work iobobadone. Cn EW— C. .' . REG|DENT(S)WILL 8EINFORMED OF POSSIBLE .E".="A`. ^ / DRIVEWAY CLOSURE —..Ipvd shoulder ROAn N APIPF' ��"C'YAS N(YTT,_"':� � U 1,�18P � 0A 1C, (Clbly DEVICE SPACING MPH TAPER ITANGENT 35145 30 1 60 PRE -INSPECTION REPORT Job #: 106321664 f CL Date: 3/22/17 Address: Jurisdiction: Edmonds City / Zip: Right of Way Permit? O YES ❑ NO Customer: Est. Start Date: 05/15/17 PM / Insp: Est. Duration: 8 Hours ......... ...SZTH AYE W WORK DESCRIPTION: 20304 87TH AVE W EDMONDS 98026 CYNTHINA MARKER 425-582-1981 Kiara Hays 425-2137205 PHONE NUMBER Construction Method Open Trench ❑ INSTALL45'OF1-1/8"PE5CATSTUBAND30'OF1-1/8"PESCATEXT 5ETA250OIL. Trenchless E] PLAT MAP: 202ND ST SW DO = Fire Hydrant (70' from tie in) W CL S G /r, = Sewer Manhole s ! �,p 1 u ,y,ry gk ^^� �mm� p I ,,i'd�"'�k�tle6p"ry�ra�rodWAto 8� = Tree it a 4 Cn PL00 i'ij(06, � I TC I a I I � I W r" I Q I r4 I I 9 L, I L,, Go FROM S PL SEWER "°m°° EXTENDS INTO LOT,�' I R .a „ ��w dpi PL m �� wN �� PL W CL S Size of Cut I Surface Type w f CL 2Q� ST SW & E of CL 87THAYE W 3X5 SOFT SURFACE 420 S f CL '. 21 MD S ,SW $� w....,,. W .. f CL ......... ...SZTH AYE W . w... ... . 2X4 _...... o. ASPHALT ..m 'N S of CL _�..... ... & ' E W of C L- ❑ FLAGGERS # MPH ❑ TROLLY LINES ❑ BUS STOP # ❑ METER HOODS # ❑ OFFICERS # SPEED LIMIT ❑ TRAFFIC SIGNAL ❑ ARTERIAL ❑ NO PARKS # ❑ Commercial ❑ Altered Commercial ❑ Leak Repair Service Information ❑ Template Bar Residential ❑ Altered Residential ❑ CP Work Diameter Meter EFV ❑ Bollards 2.5" # Multi-Family y ❑❑ Replacement Service ❑ Pothole 5/8" 250 �� 1800 ❑ Bollards 4" # New Constr. Main Maintenance ❑ Extension 11/8°' 425 ❑� 2600 Stub ❑ Service Maintenance ❑ 11/4' 630 ❑ 10,000 ❑ FUEL LINE PERMIT NEEDED 0 Extension ❑ Valve Maintenance ❑ 2" ❑ 1000 Fuel Line Length: ❑ Compete Sery ❑ Cut & Cap Mtr Loc: O/L Fuel Line Diameter: W. ro N 00 0 - LU boo S.LLZ Z " nN WY LU IL - O P co CN C14 �DAR.�p 00 00 RM Y69 N 00 LO R 00 P N �a NO 00 0. Oo P W LO LO p IL, co N p CD N NLU ` N �P P ..............�... ----- ........ ___._._. Z9YZ68 Z9VZ68 � /I I 3£L dl 3d„b/l L 0 ..., . M 00 d- O n. NO � P r P N N N Z961 n-M1S ,.Y/£ AN P .N U Ln Nolf N a o o 00 z r ('1 � IN b0 OZ YSZ8LOLOl LYZ _ O� a z