ENG20170413-APPROVED PERMIT.pdfv�OYL'
CITY OF EDMONDS
121 5TH AVENUENORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20170413
RIGHT OF WAY PERMIT 1 Permit Number: ENG20170413 Expiration Date: 05/08/2018
Job Address: 20814 82ND AVE W, EDMONDS Location: 20814 82 AVE W
APPLK ' 'ANT CONTRACTOR
SNOHOMISH COUNTY PUD SNOHOMISH COUNTY PUD
P.O. BOX H P O BOX H
EVERETT, WA 98206 EVERETT, WA 98206
(425)670-3216
LICENSE #: EXP:
1: 11. 1►
Replace B/O pole at above address. Reference expired permit ENG20120182
DISRLJPTION INFORMATION
ASSESSED VALUE: $0.00 PROPERTY AREA: 0
SIDEWALK: (OXO) DURATION IN MONTHS: 0 FEE: $0 00 STREET DISRUPTION TRENCH CUT: ( 0 X 0 )
PARKING: ( OXO) DURATION IN MONTHS: 0 FEE: $0,00 YEAR OF OVERLAY: 0 FEE: $0.00
ALLEY I 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 ofany kind or description Whatsoever, foreseen or unforeseen, that may be 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
atCorney fees by reason ofgranting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OFONEYEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCEOFTHEWORK.
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 NOTICEREQUIRED FOR ALL INSPECTION REQUESTS
THIS APPLICATION IS NOTA PERMITUNTTL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPTIS ACKNOWLEDGED IN
SPACE PROVIDED.
Printed: Wednesday, November 08,201
ii/8/20i7
RELEASED BY
DATE
❑ FILE COPY ❑ INSPECTOR COPY ❑ APPLICANT COPY
STATUS: ISSUED
ENG20170413
• 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.
• 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 aresult of construction activity are exempt from the noise limits
of ECC Chapter 5.30 only during the hours of 7:00am to 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 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 fromthe issuance ofthis permit. Issuance ofthis 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
PARTIAL INSPECTION
FINAL INSPECTION APPROVED
DATE: INITIAL: NOTES:
DATE: INITIAL: NOTES:
DATE: INITIAL:
of EVti104, RECEIVE[)
OCT 10 2011
ROW PERMIT NO.: ENGJ01 `-OBI 1,�
BUILDING ISSUE DATE:
l,f �.. RIGHT-OF-WAY CONSTRUCTION
INc• `�y`' PERMIT APPLICATION
PROJECT NAME:?4-PL 3105�2!E oa $ 2-N�,�J CONTACT:
CONTRACTOR: Plione #: y2� �33J i
Mailing Address: ra•.• ,-3 ax 110-7 Fax #:
State License #:
City Business License #:
Email #: cxptAsQ,-�-Z) 540P%,0 •cam►+.-k-
❑ Liability Insurance U Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: a O$ l y g •Z N� &k6f lnJ
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJEC'I':
Commercial
❑ Multi -Family
Subdivision
❑ Single Family
rvf EUC (PUD, VERIZON, PSE,
Pi
COMCAST, OV WSD):
Is this permit part of a blanket permit?
City Project
❑ Other
❑ Yes ❑ No
ANY ASSOCIATED PERMITS? BLD# ENG#
Traffic Control (Only)
DESCRIPTION OF PROPOSED WORK (Be Specific) : 4-ct
A (�-,, Nco e« 5 RCrr..., c.4- e.0 o a r ;� c.e.n� Ii Feu U 1oa z o 18Z
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES NO 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
AREA
CLOSURE
TOTAL
DURATION
(NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF
X
X
LF
LF
LF
SF
Alley 72 His + LF
SF
Parking 72 Hrs + LF
X
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 staKylients and understand the permit requirements and acknowledge that I nnist
follow all requirement it rder for the permit to be valid.
SIGNATURE 1 DATE
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
L
LANE CLOSURE ON A TWO-LANE LOW -VOLUME ROAD
(ONE FLAGGER OPERATION)
AD
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W 2 0 - 4 ROAD
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SIGN
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(FT)
25
200
55
30
200
85
35
350
120
40
350
170
45
500
220
50
500
280
55
500
335
rr
r
IApplicant _hall rapalrlreplace all damage to 1
i uii!itiQs or Ftollt=:(, 9 imorouaments in City
rght_of-wmy p,3l ,"ry standards that is caut-ed
-sr occurs dur►ncl thvo permitted project. 1
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. . -�? ► ENGINEERING
SNOHOMISH COUNTY
TRAFFIC CONTROL PLAN
IC UHL11Y TRICT NO 1
PROJECT REPLACE 80 POLE
LOCATION 20814 82ND AVE W, EDMONDS 98026
ENGINEER SHANE MAHONEY DATE 4/26/12 WO NO _381894/03
PHONE 425-670-3205
CELLULAR 425-388-1495
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PUBLIC UTILITY DISTRICT NO.1 OF SNOHOMISH COUNTY MR# 235901
LOCATION 20814 82ND AVE W. EDMONDS 98026 SOUTH COUNTY AREA
POLE NO. SE 1/4S 19 T 27 R 04 DATE 4/26/12 _- W.O. NO. 381894
REASON FOR WORK REPLACE PRI-5 80 POLE _ ENGINEER MAHONEY TASK 03
DRAFTER U.G. NO.
- - - SCALE 1" = 60'
(APPROVED
{ & DATE PRINTED
DATE WORK COMPLETED
FOREMAN
FEES REQ'D ❑ YES ■ NO
PRIMARY OVERHEAD
❑ RESIDENTIAL
❑ COMMERCIAL
LEO NO,
SECONDARY OVERHEAD
BASIC FEE S
PERMITS (DATE GRANTED)
❑ TREE TRIM
❑ STATE __
@$ =8. _
METER/CONY. POLE g
PRIMARY UNDERGROUND
❑ RESIDENTIAL
❑ COUNTY
■ CITY 7/ 16/ 12
❑ COMMERCIAL
BASIC FEE S
■ EDMONDS ENG20120182
EASEMENTS
LEU NO._
❑ REQUIRED ■ NOT REQUIRED
SECONDARY UNDERGROUND
—
BASIC FEE S
—
'@8 =$
DATE RELEASED
UNDERGROUND PLAT
FOREIGN CONTACTS
■ JPN# 674E12
BASIC FEE S
_
(Z FT.@S '=g
❑ JOINT TRENCH FRONTIER & CATV
❑ JOINT BORE FRONTIER & CATV
STREET LIGHTING
ri FT.@S '_$
-
POLE STENCILING
WORK IN RIGHT OF WAY
FROM TO
❑ PRIMARY
TAKE OFF POLE
❑ SECONDARY
PRE-CONST. REQUIRMENTS
❑ TREE TRIM ❑ PUD LOCATOR
q FT.@S '=8
MISCELLANEOUS FEES
❑ BACKHOE ■ FLAGGING
VAULT S _
ONE CALL DATE ON FORM
PERMIT S
No.
STREET LIGHTING
■ YES ❑ NO
$
S
READY
PHASING
S --
GIS
IWORKING
TOTAL DUE 8_
1 LINE
POLE/
FINISHED xFA(�
DATE PAID
RECEPT NO. IJOINT USE
SERVICE ORDER NO. LOCATION MAP PAGE 454 J-6
LEGEND:
o EXISTING POLE
X EXISTING POLE -TO BE REMOVED
® NEW POLE
X NEW POLE TO REPLACE EXISTING POLE
DATE_
SUBSTATION PERRINVILLE
CIRCUIT NO. 126 PHASE 1.2.3
ENGR'S TEL. #
425-783-4394
ENGR'S CELL #
425-512-3526 N
SCHEMATIC
NTS
OA POLE 9754
• SET 55' CL-1 POLE TIGHT NORTHWEST OF EXISTING POLE AS STAKED - SET POLE
12' DEEP - POLE WILL BE FRAMED AS A 50' POLE
• FRAME POLE PER ASSEMBLYVS 12008 AND 12V115
•TRANSFER 3-PHASE PRI& NEUT TO THE NORTH & EAST AND 1-PHASE PRI& NEUT
TO THE SOUTH AND FUSE 0 15 AMPS
• INSTALL NEW DOWN GUYS & ANCHORS TO THE SOUTH L■8' AND WEST LmT
• TRANSFER SL-110662-A AND (3) OH TPX SERVICES
•STRIP, TOP AND ABANDON OLD POLE TO PHONE/CATV
123
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208TH PL SW
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4-222058
SL-1833-D 0 FU25 - -- -
1 4-52 4-212103 119
50-5667 ?0807
A �20806 11-11- 1/02
123
208TH PL SW
20814
20 813 4-2220 8 9112
1 SL-110662-A '; � 3
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<50 74 SL-50 --
832 1
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1 - 64292
22205
;
2090
20905
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