ENG2021-0089 ROW PERMITRIGHT OF WAY EUC PERMIT
PERMIT NUMBER
City of Edmonds
www.cityofedmonds.gov
Description: PSE-CUT AND CAP GAS SERVICE AND INSTALL NEW GAS SERVICE
ISSUED: 03/24/2021
Address: 10727 226TH ST SW EDMONDS WA 98020-6132
EXPIRES: 09/24/2021
Permit Type: RIGHT OF WAY EUC Permit Subtype: MINOR Parcel Number: 27032500310300
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 JOHANNESSEN JOHN M CREDIT 10727 226TH ST SW, EDMONDS WA 98020-6132
TRUST
INFORMFEE
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.
77 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.
THIS DOCUMENT IS NOT VALID UNTIL FEES ARE PAID AND THE CITY ENGINEER OR HIS/HER DEPUTY HAS SIGNED BELOW
03/24/2021
RELEASED BY
DATE
Printed: Wednesday, March 24, 2021 10:20:19 AM 1 of 2
-KRWOF WAY EUC PERMIT
City of • • •
www.cityofedmonds.gov• •
CONDITIONS
CONDITION TYPE
Easement and/or permission from adjacent property owner is required prior to entry or work within
ADJACENT PROPERTY
an adjacent property.
It is the owner's responsibility to repair/replace all damage of utilities or frontage improvements in
DAMAGE TO FRONTAGE
City right of Ways or Easements to City Standards caused by or occurring during the permitted
IMPROVEMENTS
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 REQ
Maintain erosion and sedimentation control per City and SWMMW standard requirements.
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
SOUND OR NOISE
weekdays and 10:OOam 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.
TRAFFIC CONTROL
Traffic Control per approved plan and MUTCD. All Flaggers shall be certified.
All utilities shall be located prior to any excavation. New locates shall be called for if at time of
UTILITY LOCATES
excavation, original locates are no longer identifiable.
INSPECTIONS
INSPECTION TYPE
DATE
RESULT
COMPLETE
A-1 JOB START
X-2 ENGINEERING FINAL"
E-7 RESTOR LIMITS
Printed: Wednesday, March 24, 2021 10:20:19 AM 2 of 2
RECEIVED
0\ t u,tl(-).
"VC. I S'� J
MAR 15 2021
CITY OF EDMONDS
DEVELOPMENT
SERVICES DEPARTMENT
ROW PERMIT NO.: ENG2021-0089
ISSUE DATE: 3/24/21
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: 109136148
CONTACT: Susan Sidick
CONTRACTOR: PSE/Infrasource Phone #: 425-457-6353
Mailing Address: 1660 Park Lane Burlington Wa 9823Yax #:
State License #: INFRASL87I C2
City Business License #:
Email #: susan.sidick@pse.com
❑ Liability Insurance ❑ Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 10727 226th ST SW
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 cut and cap gas service and install new gas service at approx 12' N c/1 of 226th ST
SW & 281' W of private dr & 486' W c/1 of 106th AVE W (1) 3x4 grass cut & (1) 3x5
paving grass cut anticipated Un er jo
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES ❑ NO ❑ Year:
PAVEMENT CUT: ® 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 Susan Sidick
Contractor or Agent
DATE
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Puget Sound Energy
Traffic Control Supervisor:
Yuriy S. Bashtovoy
Card No. 011687
Card Exp. 06/30/2022
Yuriy.Bashtovoy@pse.com
(425)424-660
loefoid pall1wied ayl 6ulanp sin000
ao pasneo sl leyl spiepuels Allo aad
AeM-;o-}y61J AJ!0 ul s}uauaanadwi
96eluoa; ao sallllRn of abewep
Ile aoeldaa/aledaa lleys;ueollddy
MO
W3-4
GoNa�\N �o
PRINT ON 11 X 17
SHEETS ONLY
TEMPORARY TRAFFIC CONTROL PLAN
• 10727 226th St SW
\V Edmonds
WA 98020
USA
I
RESIDENT(S) WILL BE INFORMED
OF POSSIBLE TEMPORARY
DRIVEWAY CLOSURE
226TH ST SW
/'
�P
N OV3HV
avow
w
w
Q
r,
4ti� x
PLACE W20-1 SIGNS ON ALL
ADJACENT STREETS WITHIN
FEET OF WORK AREA
BE X
REPARED
0
TO ROAD
o ROADTOPo W2o-4 WORK
L AHEAD
WORK N
AHEAD 7�
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 State Routes and Hwys.
4. Sign size can be a minimum of 30" x 30" 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 12' NCL of 226th St SW & 281' WCL
of Pvt Rd (?) & 486' WCL of 106th Ave W.
e%
PLACE SIGNS
BOTH SIDES OF
WORK AREA
2
_ W*S
60
SIGN SPACING
55 +
„x„
60/65
800
45/55
500'
35/40
350'
30
200'
25
100,
W3-4
b-OZM
b'L-OZ l•-OZM
aow
�
o��
100, N 100, N 100,
0' 35' 70'
CHANNELIZATION
DEVICE SPACING
MPH TAPER TANGENT
55/70 40 80
35/45 30 60
25/30 20 40
MINIMUM TA
LANE
WIDTH
20
25
POSTEI
30 35
10
11
70
105
150 205
165 225
75
115
12
80
125
180 245
PUGET
� SOUND
ENERGY
JOB#109136148
10727 226th St SW, Edmonds, WA
March 10, 2021
Yuriy.Bashtovoy@pse.com
(425)424-6603
SHEET 1 of 1
1N3S AIAa3s
d4
O Sd0 lll0
3AI303M
M1_ : a M plow
RECEIVED
Job #:
Date:
Jurisdiction:
ROW Permit:
Est. Start Date:
Est. Duration:
109136148
3/2/21
Edmonds
Yes
5/3/21
2 Days (16 Hours)
Puget Sound Energy Gas Pre -Inspect Form
Address:
City / Zip:
Customer:
PM / Inspector:
MAR 15 2021
CITY OF EDMONDS
DEVELOPMENT
10727 226TH ST SW SERVICES DEPARTMENT
EDMONDS, 98020
Leif Helleren 425-770-1970
kevin Williams 425-691-7573
Job Description / Scope of Work
From 2" STW main in ROW run 1-1/8 altered service and tie back to existing 1-1/8 service in
New Construction:
property of 10727 eliminating trespass (100' scat with 100' plat and 88' existing) re-hange
No
Construction Method
existing meter in same location
@ Inches
All Scat / Trenchless
' lE 267.9'(NMMdE) O '�` :•}i:':i'::'i}'::.'::1 �" /
jCO 6'emz74(sp
yyII Om
DRAIN
/ as �: �:':;: • �
EXlS77NG NlFQTRA77LYH SYSTEaI \
m FOR HOUSE ON LOT 3 \ •..:..
i i
Z
Existing home and •:•.
__
1-1/8" PE service rf� ;' ;' ;;�,F,�'�''�,�/ F �, �'�i;•f?'.',� X
EASDIENT
' I I
- - - - - - - - - - - - - - - \.•"1
�/
,� ;
1
�J
CONNECT EX GAS Lr I r�'..'•••
I R 70 NEW SERVICE I 'E (TYP% `• :•:,ff
PRQPOSED !0' PRrVA7t I F•:�t:
I UT$lTY EASEMENT I I �:
1-1/8" PE `w� ?
/
jPlat
{ 4
Scat I E
I \ ti'ita> I
l '
I M * CDF NOT PERMITED IN THE ROW
LU
* MAINTAIN MINIMUM 3' HORIZONTAL AND 1'
'
VERTICAL FROM WATER, SEWER AND STORM
'
I I 20'PRYI 47E ON PRIVATE PROPERTY
--— — — — — — — — —
I ACCESS &.. .. .. ....
- ----- I I U7XITY .:'•`.'•':•i:'•i:'•::'•-
T
`
' r / --- '
-- �'
FfASEME
AWSTAU ASPHALT dllW YOct?
� I Sn
APPROACH CDF DETAA 5M I PRO DRY _ ,d:::: '•':i:;;' /p
(SWOETAtt QV SHT DT-Ol I I UiW Sims ,•:{:ti::; :::; ':;
To COT Cut and cap
U7iLnyD„,T,�
I existing service �I
FA MY
ie meev1 '•':': �""'�: y'�' 1
226th ST SW
w
T
2" SIWJ P 11rN.
Q
1.T
— —
jai— — — — Storm
— —
20Edmonds ROW
'
67C"-84+,
w w
U. Water
20' Woodway ROW CD
Work
Location
Size of Cut
Surface Type
12'
N
of CL
226th ST SW
&
281'
W
of CL
Private DR
3x4
Grass
12'
N
of CL
226th ST SW
&
486'
W
of CL
106th AVE W
3x5
Asphalt/Grass
of CL
&
of CL
Service Information
Street Information
Job Type
Diameter:
1-1/8" PE
Flaggers #:
Yes
Arterial:
Altered Residential Svc
EFV:
1-1/8" - 1800 - 9996741
Police #:
TCP:
Yes
Tie -In Fitting
Meter:
A425
Speed Limit:
25
No Parks #:
Steel - 1-1/4" x 1-1/4" - Style
H17501 - MOP (1440)
Meter Loc:
Existing
Trolley Lines:
Mtr Hoods #:
Del Press:
6" W.C.
Traffic Signal:
I
Bus Stop:
I
�—
Bollards:
2.5" #
1
4"
#
I ADA Ramps #:1
Route #Is: