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ENG2020-0379RIGHT OF WAY EUC PERMIT PERMIT NUMBER City of Edmonds -0379 www.cityofedmonds.gov Description: PSE INSTALL GAS SERVICE ISSUED: 10/12/2020 Address: 20429 85TH PL W EDMONDS WA 98026-6610 EXPIRES: 04/12/2021 it Type: RIGHT OF WAY EUC Permit Subtype: MINOR Parcel Number: 00544600003502 I 11-14111 a W NAME TYPE NAME ADDRESS PHONE APPLICANT PSE/INFRASOURCE 1660 PARK LANE, BURLINGTON WA 98233 (425)457-6353 CONTRACTOR PSE/INFRASOURCE 1660 PARK LANE, BURLINGTON WA 98233 (425)457-6353 OWNER MONTAGUE GRANT R 20429 85TH PL W, EDMONDS WA 98026-6610 FEE INFORMATION DESCRIPTION AMOUNT PAID CITY TECHNOLOGY FEE CHARGED PER PERMIT $40.00 $0.00 ENGINEERING INSPECTION FEE $110.00 $0.00 RIGHT OF WAY MINOR - EUC PERMIT FEE $110.00 $0.00 • REQUIREMENT TYPE NOTES TRAFFIC CONTROL 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 posession. RESTORATION 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 WARRANTY The contractor is responsible for workmanship and materials for a period of one year following the final inspection and acceptance of the work. INSPECTION SCHEDULING: WWW.MYBUILDING PERMIT.COM 24 HR NOTICE REQUIRED 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 granting this permit. :»•AF9:1H ]1 THIS DOCUMENT IS NOT VALID UNTIL FEES ARE PAID AND THE CITY ENGINEER OR HIS/HER DEPUTY HAS SIGNED BELOW 10/12/2020 DATE Printed: Monday, October 12, 2020 10:47:49 AM 1 of 2 -KRWOF WAY EUC PERMIT PERMIT NUMBER City of • • • www.cityofedmonds. ov/425.771.0220 CONDITIONS CONDITION TYPE Easement and/or permission from adjacent property owner is required prior to entry or work within ADJACENT PROPERTY an adjacent property. Contractor/Owner shall be responsible for repair/replacement of all damage to utilities and/or DAMAGE TO FRONTAGE frontage improvements in city right of way per city standards that is caused by or occurs during the IMPROVEMENTS permitted project. Alert affected residents and/or businesses prior to work start. Verify clear bore crossings. ENGINEERING OTHER Restore landscape to like or better conditions. Call for required inspections as noted. ESC REQUIRED Maintain erosion & sediment control per city standards. 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 HOLD HARMLESS any and all claims for damages of whatever nature, arising directly or indirectly from the issuance of this permit. Issuance of this permit shall not be deemed to modify, waive or reduce any requirements of any City ordinance nor limit in any way the City's ability to enforce any ordinance provision. 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 7:00am to 6:00pm on SOUND OR NOISE weekdays and 10:00am to 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. UNDERGROUND UTILITY Call for locates of underground utilities prior to any excavation. LOCATES !IMOL INSPECTION TYPE DATE RESULT NOTES lip COMPLETE X-2 ENGINEERING FINAL** E-7 RESTOR LIMITS Printed: Monday, October 12, 2020 10:47:49 AM 2 of 2 0 \:L L?,11(7. ANC. 1 s`) u PROJECT NAME: CONTRACTOR: ROW PERMIT NO.: ENG 2020-0379 ISSUE DATE: 10/12/20 RIGHT-OF-WAY CONSTRUCTION PERMIT APPLICATION 106370595 CONTACT: Susan Sidick PSE/infrasource Phone #: 425-457-6353 Mailing Address: Fax #: 1660 Park Lane Burlington Wa 98233 State License #: INFRASL87IC2 Email #: susan.sidick@pse.com City Business License #: ❑ Liability Insurance ❑ Bonded ADDRESS OR INTERSECTION OF CONSTRUCTION: 20429 85th PL W ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT: ❑ Commercial ❑ Subdivision ❑ City Project ❑ Traffic Control (Only) ❑ Multi -Family ❑ Single Family ❑ EUC (PUD, VERIZON, PSE, COMCAST, OVWSD): Is this permit part of a blanket permit? ANY ASSOCIATED PERMITS? ❑ Other ❑ Yes ❑ No BLD# ENG# DESCRIPTION OF PROPOSED WORK (Be Specific) : To install gas service at approx 15' W c/1 to I F E c/1 of 85th PL W to 190' S c/1 of 204th ST SW (1) 3x5 soft surface (1) 3x3 paving cut & (1) 3x5 soft surface paving cut anticipated. WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES ❑ NO ❑ Year: PAVEMENT CUT: ❑x Yes ❑ No If yes, indicate size of cut: 3 x 5 CONCRETE CUT: ❑ Yes ❑ No If yes, indicate size of cut: x RIGHT-OF-WAY CLOSURE AREA 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 order for the permit to be valid. SIGNATURE 6)MIQ61QIN Contractor or Agent DATE NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Puget Sound Energy Traffic Control Supervisor: Gregory Harwood Card No. 012238 Card Exp. 09/30/2023 gregory.harwood@pse.com (425)424-6425 Applicant shall repair/replace all damage to utilities or frontage improvements in City right-of-way per city standards that is caused or occurs during the permitted project. OWNER/CONTRACTOR IS RESPONSIBLE FOR EROSION CONTROL AND DRAINAGE ENGINEERING DIVISION APPROVED AS NOTED LEGEND ® 28" TRAFFIC CONE ® WORK PIT TRAFFIC FLOW FLAGGER WORK VEHICLE/ FLASHING LIGHTS SIGN LOCATION RIGHT OF WAY Row SIGN SPACING MPH "X" 60/65 1000, 45/55 500' 35/40 350' 30 200' 25 1 100' TEMPORARY TRAFFIC CONTROL PLAN PUGET SOUND ENERGY JOB# 106370595 20429 85TH PL W, EDMONDS, WA 9/21 /2020 bob.danskin@pse.com 425-398-6168 SHEET 1 of 2 CL I� 9' 9 CO b�4 END ROAD WORK 17 r'o �d o0 W3 4 �0 10'10 v bl4 CREW SHALL POTHOLE FOR WATER MAIN DEPTH PRIOR TO PROJECT START END ROAD WORK CHANNELIZATION DEVICE SPACING MPH TAPER TANGENT 55/70 40 80 35/45 30 60 25/30 20 40 'I .I W o� _ O = D n • PARKING tl3tltl AtlMtl MOl ; cn m aao."o �a.D�i TOW AWAV AREA sNl�lavd . � m � mCn D pp Cn L C n 3 _ o C _ U 3 i 0 #20429 a ti N W3-4 ONE LANE p ROAD CV AHEAD ROAD ; WORK o AHEAD Notes: 1. All signs and spacing to conform to the MUTCD and City of Edmonds standards. 2. All sidewalks, driveways, exits and egresses shall be completely clear unless otherwise indicated. 3. Channelizing devices are 28" traffic cones. Use traffic drums (barrels) with steady burning Type C lights on all State Routes and Hwys. 4. Sign size can be a minimum of 36" x 36" and shall not obstruct pedestrian access. 5. Crew is required to leave a minimum of 11' for traveling lane width. 6. Alert affected residents and businesses. 7. Work to take place between 9 a.m. and 4 p.m unless otherwise specified. All work for arterials and major roadways will be from 9 a.m. to 3 p.m 8. Work area will be 15' WCL 85th PI W & 190' SCL 204th St SW, 0' WCL 85th PI W & 190' SCL 204th St SW, 11' ECL 85th PI W & 190' SCL 204th St SW. 9. If used, place NO -PARK signs 72 hours in advance of the day that the work is to be done. Puget Sound Energy Traffic Control Supervisor: Gregory Harwood Card No. 012238 Card Exp. 09/30/2023 gregory.harwood@pse.com (425)424-6425 LEGEND ® 28" TRAFFIC CONE ® WORK PIT TRAFFIC FLOW FLAGGER WORK VEHICLE/ FLASHING LIGHTS SIGN LOCATION RIGHT OF WAY ROW SIGN SPACING MPH "X" 60/65 1000, 45/55 500' 35/40 350' 30 200' 25 1 100' TEMPORARY TRAFFIC CONTROL PLAN J CL F— LO co PUGET SOUND ENERGY JOB# 106370595 20429 85TH PL W, EDMONDS, WA 9/21 /2020 bob.danskin@pse.com 425-398-6168 SHEET 2 of 2 END ROAD WORK CHANNELIZATION DEVICE SPACING MPH TAPER TANGENT 55/70 40 80 35/45 30 60 25/30 20 40 I O _ O = D v3av AVMvnnoi (n m a ORKIo p of O ' ^ TOW AWAY AREA �JNINi1Vd . ;U M 5 mCn > 0 Cn F=— co #20429 Q N -4 W3 NE LANE p ROAD CV AHEAD 'ROAD WORK N AHEAD Notes: 1. All signs and spacing to conform to the MUTCD and City of Edmonds standards. 2. All sidewalks, driveways, exits and egresses shall be completely clear unless otherwise indicated. 3. Channelizing devices are 28" traffic cones. Use traffic drums (barrels) with steady burning Type C lights on all State Routes and Hwys. 4. Sign size can be a minimum of 36" x 36" and shall not obstruct pedestrian access. 5. Crew is required to leave a minimum of 11' for traveling lane width. 6. Alert affected residents and businesses. 7. Work to take place between 9 a.m. and 4 p.m unless otherwise specified. All work for arterials and major roadways will be from 9 a.m. to 3 p.m 8. Work area will be 15' WCL 85th PI W & 190' SCL 204th St SW, 0' WCL 85th PI W & 190' SCL 204th St SW, 11' ECL 85th PI W & 190' SCL 204th St SW. 9. If used, place NO -PARK signs 72 hours in advance of the day that the work is to be done. Job #: Date: Jurisdiction: ROW Permit: Est. Start Date: Est. Duration: 106370595 9/15/20 Edmonds Yes 11 /6/20 1 Day (8 Hours) Puget Sound Energy Gas Pre -Inspect Form Address: City / Zip: Customer: PM / Inspector 20429 85th PI W Edmonds, 98026 Michael Finnev (253) 670-4181 Noah Fowler (425) 375-3242 Job Description / Scope of Work Install a 45' 1-1/8" PE SCAT stub and a 60' 1-1/8" PE SCAT extension from a 2" MPE IP main on New Construction: o 85th PI W. Set an A425 meter at inches, located O/L of the home. Construction Method All Scat / Trenchless PLAT Map: 163.068 004TH ST SW II I I II I I o II 1 SERVICE LINE MUST MAINTAIN A 5 1 MINIMUM OF V VERTICAL AND 5' 11 I HORIZONTAL SEPERATION FROM If I OTHER UTILITIES IN THE ROW �- I ,S II II 1 4 60' A425 Tie in 1 1-118" PE 1 1 �o I 1 1 0 1 20429 If 0 1 1 II �14 1 1 II I 1 60' ROW cc oc W W N N O N Work Location Size of Cut Surface Type 15' West of CL 85th PI W & 190' South of CL 204th St SW Tx 5' Soft 0' West of CL 85th PI W & 190' South of CL 204th St SW Tx 3' Asphalt 11' East of CL 85th PI W & 190' South of CL 204th St SW Tx 5' Soft/Asphalt Service Information Street Information Job Type Diameter: 1-1/8" PE Flaggers #: Arterial: Residential Conversion SVC EFV: 1-1/8" - 2600 - 9999144 Police #: TCP: Tie -In Fitting Meter: A425 Speed Limit: No Parks #: MDPE - 2" IPS - (DIA) 1"CTS Meter Loc: 03 - OL Trolley Lines: Mtr Hoods #: Del Press: 6" W.C. Traffic Signal: Bus Stop: ® Bollards: 2.5" # 4" # ADA Ramps #: Route #'s: