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ENG2021-0220 ROW PERMITOF WAY EUC PERMIT PERMIT NUMBER City of Edmonds AveRIGHT 980 1 1 1 www.cityofedmonds.gov Description: PUD-REPLACE BO POLE ISSUED: 07/06/2021 Address: 7512 BRAEMAR DR EDMONDS WA 98026-5137 EXPIRES: 01/06/2022 Permit Type: RIGHT OF WAY EUC Permit Subtype: STANDARD Parcel Number: 00513500001901 NAME TYPE NAME ADDRESS PHONE APPLICANT SNOHOMISH COUNTY PUD P.O. BOX 1107, EVERETT WA 98206 (425)670-3216 CONTRACTOR SNOHOMISH COUNTY PUD P.O. BOX 1107, EVERETT WA 98206 (425)670-3216 OWNER BICKEL DWIGHT A & VERGASON 7512 BRAEMAR DR, EDMONDS WA 98026-5137 LUCINDA J INFORMFEE DESCRIPTION AMOUNT PAID CITY TECHNOLOGY FEE CHARGED PER PERMIT $40.00 $0.00 RIGHT OF WAY STANDARD - EUC PERMIT FEE $330.00 $0.00 • ; 1l 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. THIS DOCUMENT IS NOT VALID UNTIL FEES ARE PAID AND THE CITY ENGINEER OR HIS/HER DEPUTY HAS SIGNED BELOW Q T 07/06/2021 RELEASED BY DATE Printed: Tuesday, July 06, 2021 8:06:13 AM 1 of 2 -KRWOF WAY EUC PERMIT City of • • • Ave•:• • ENG2021-0220 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. 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 RESULT INSPECTION MEN A-1 JOB START X-2 ENGINEERING FINAL" Printed: Tuesday, July 06, 2021 8:06:13 AM 2 of 2 of EDA4 RECEIVED RIGHT OF WAY CONSTRUCTION J U N E 16 2021 PERMIT APPLICATION �I Complete and submit this Application in accordance with the Submittal CITY OF EDMONDS p pp DEVELOPMENT /,%/C. 1390 Requirements outlined in Right -Of -Way permit Handout E63. SERVICES DEPARTMENT If any field is not applicable to your project, write "N/A" instead of leaving blank. All fields required. Incomplete Applications will be denied. SECTION A General • Project Name Replace Utility Pole (WO i00069874) Site Address or if no site address use Property Address at NW corner of project area: 7512 Braemar Dr, Edmonds Associated Permits: BLD PLN ENG HoldingOwner and Entity Name of Company Snohomish County PUD #1 Franchise Ordinance No: N/A Point of Contact Ben Ice Title Engineer Address PO Box 1107 City Everett State WA Zip 98206 Phone 425.783.4355 Email btice@snopud.com &jointuse@snopud.com Contractor and Authorized Agent of Owner Name of Company Same as above (see note below) Contractor Contacts During Construction Primary Name Agent Name Title Title Mobile Address Email City State Zip Secondary Name Phone Title Email Mobile City of Edmonds Business License No: Email State License No: N Contractor verifies it is currently bonded 1] Contractor verifies it currently has general liability insurance NOTE: ECDC 18.6o.o2o requires that the Application be signed by a licensed and bonded contractor unless otherwise approved by the city engineer. ❑ Multifamily residential ❑ Commercial ❑ City project ❑ Single family residential subdivision ❑ Single family -other ❑ Industrial ❑ Demo and rebuild or from vacant land? ❑ Other, please specify: ❑ Utility Franchise Work associated with development (check one of the above boxes as welt ❑ Traffic Control Only (no associated development) • Utility Franchise Work (no associated development) City of Edmonds ROW construction permit Application --Page 1 of 3 Updated 3/25/2021 Include an overall narrative description of the proposed work. Be specific and detailed: Describe infrastructure to be impacted, such as, poles, wires, conduit, utility mains, etc. Include whether this is construction, maintenance, or repair. Include description of proposed construction methods, (e.g., bores, trenches, overhead wires proposed, depth for underground utilities, etc.) Replace existing, damaged pole with new. New pole will be the same height as original and the same distance from the street. Permit to cover any necessary tree trimming. RIGHT-OF-WAY CLOSURE AREA TOTAL DURATION (Number of Months) Sidewalk 72 hours + LF I x LF SF Alley 72 hours + LF Ix I LF SF Parking 72 hours + LF Ix I LF SF SECTION B - If you are not a utility company performing work in the City ROW, skip to SECTIONC. 1. The work in the right of way is on or for the following type of facilities: ❑ telecommunications ❑ cable n power ❑ gas ❑ water ❑ sewer ❑ storm Details of Work to be Completed 1. Does the utility owner have existing overhead infrastructure in the area of work? Yes x No 2. 1 Will any equipment be added underground or above ground (e.g. pedestals, vaults, etc.)? x If yes, describe: 3. Does the proposed work connect a lot or commercial development with utilities that serve more than one lot or commercial development? X 4. Does the work involve rebuilding or relocating an existing aboveground utility system which connects a lot or commercial development to an existing underground common utility stem? X 5. Does the work involve proposed additions to an aboveground utility system? If es: x Are the additions for the purpose of serving new commercial development? Are the additions for the purpose of serving a single-family residential subdivision? Details of Work to be Completed Yes No 6. Does your project involve rebuilding or replacing utility equipment which currently serves more than one lot or commercial development? x If yes, answer the following questions related to project area, i.e. the actual area in which the project is proposed: 6a. Does your project involve wires/cables/lines? If yes: X How many are existing? 13 1 How many are to be added? I o City of Edmonds ROW construction permit Application --Page 2 of 3 Updated 3/25/2021 6b. Does your project involve poles? If yes: X How many poles are existing in the project area? 1 What is the height of the existing poles? 50' How many poles are to be removed? 0 Are additional poles to be laced? 0 How many? I I What is the height of the additionalpoles? 6c. Are any poles to be modified/rebuilt/replaced? If yes: X How many? 1 1 1 What is the height of the poles after? as' Describe the modification rebuild: Replace SECTION C Traffic Control and Public Safety. 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. Restoration shall 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. Insurance. The City may require the owner or contractor to provide proof of insurance acceptable to the City prior to any permit approval. Indemnification. The Applicant agrees to defend, indemnify, and hold harmless the City of Edmonds, its officials, officers, employees, and agents against any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, including defense costs and attorney fees, resulting directly or indirectly from any act or omission of the Applicant, its subcontractors, anyone directly or indirectly employed by them, and anyone for whose acts or omissions they may be liable, arising out of, related to, or by reason of the granting of this permit; and specifically including but not limited to all loss by the failure of the Applicant to fully or adequately perform, in any respect, all authorizations or obligations under the permit. These indemnification requirements shall survive the expiration, revocation, or termination of any resulting permit approval. Acceptance of terms, conditions, and requirements. Applicant accepts the terms, conditions, and requirements set forth in this Application and agrees they apply to any resulting permit and shall comply with them to the satisfaction of the City Engineer. Applicant further agrees to comply with the conditions listed on the Submittal Requirements; with all applicable city ordinances, including but not limited to ECDC Title 18; and with all applicable requirements of state and federal law. Statement of Applicant. I declare under penalty of perjury under the laws of the State of Washington that: I am a licensed and bonded contractor; the information provided herein is correct and complete; and I am authorized by owner to act on its behalf and have authority to bind the owner to this application. Fees. The Applicant is responsible for all permit fees. APPLICANT SIGNATURE: - DATE: 6/15/2021 APPLICANT PRINTED NAME: Benjamin ice APPLICANT TITLE: engineer NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE City of Edmonds ROW construction permit Application --Page 3 of 3 Updated 3/25/2021 ROAD W20-1 WORK AHEAD O ONE LANE W20-4 ROAD = AHEAD Q W3-4 L 0 W20-7A . Q OLn w � < 0 0 m 0 0 0 0 0 1 0 0® �= 0 Z� �2 0 0 Z LZJ �Q 0 N J J 0 JZ N 0 0 O Ln 0 SCHEDULE ALL INSPECTION THROUGH ct MYBUILDINGPERMITS.COM W Q- LO OWNER/CONTRACTOR IS RESPONSIBLE FOR 0 EROSION CONTROL AND DRAINAGE 0 Ln s W20-7A <i Applicant shall repair/replace all damage to utilities or frontage O W3-4 Ln ONE LANE improvements in City right-of-way s ROAD W20-4 per city standards that is caused or AHEAD occurs during the permitted project. ENGINEERING DIVISION ROAD i WORK W20-1 AHEAD APPROVED AS NOTED OWNER/CONTRACTOR RESPONSIBLE FOR LOCATING /I %p�� WQ.i,7��07/01/2021 ALL ON SITE UTILITIES. RELOCATION/REVISION TO ANY UTILITIES MAY REQUIRE A SEPERATE PERMIT. SNOHOMISH COUNTY GFCUM D� TRAFFIC CONTROL PLAN PUBLIC UTILITY DISTRICT NO 1 PROJECT REPLACE DEPRECIATED POLE LOCATION 7512 BRAEMAR DR, EDMONDS ENGINEER BEN ICE DATE 6/10/2021 ORDER 100069874 PHONE 425.783.4355 � O PUBLIC UTILITY DISTRICT NO.1 OF SNOHOMISH COUNTY LOCATION 7512 BRAEMAR DR, EDMONDS LYNNWOODAREA POLE N0. 4791, ETC SW1/4S 8 T 27 R 4 DATE 1/26/2021 ORDER 100069874 REASON FOR WORK REPLACE DEPRECIATED POLE ENGINEER BEN ICE OPERATION 0030 DRAFTER U.G. NO. SCALE NOTED APPROVED & DATE PRINTED DATE WORK COMPLETED FOREMAN FEES REQ'D ❑ YES ■ NO PRIMARY OVERHEAD ❑ RESIDENTIAL ❑ COMMERCIAL LEO NO. @$ _� SECONDARY OVERHEAD NESC VIOLATIONS BASIC FEE E ■ NO ❑ YES (SEE NOTES) @$ .=s PERMITS (DATE GRANTED) ❑ TREE TRIM ❑ STATE METER/CONV. POLE g PRIMARY UNDERGROUND ❑ RESIDENTIAL ❑ COUNTY ❑ COMMERCIAL ■ CITY BASIC FEE ❑ EASEMENTS LEU NO. @$ _� ❑ REQUIRED ■ NOT REQUIRED SECONDARY UNDERGROUND BASIC FEE DATE RELEASED @$ .=$ UNDERGROUND PLAT FOREIGN CONTACTS ■ JPN# BASIC FEE E ri FT.@S _$ ❑ JOINT TRENCH ZIPLY & CATV ❑ JOINT BORE ZIPLY & CATV STREET LIGHTING FT.@S '=3 ❑ POLE STENCILING WORK IN RIGHT OF WAY FROM TO ❑ PRIMARY TAKE OFF POLE ❑ SECONDARY PRE—CONST. REQUIRMENTS ❑ TREE TRIM ❑ PUD LOCATOR ri FT.@S '=g MISCELLANEOUS FEES ❑ BACKHOE ❑ FLAGGING VAULT 8 ❑ ONE CALL DATE PERMIT $ STREET LIGHTING $ ❑ YES ■ NO $ M&R AS -BUILT s GIS TOTAL DUE S DATE PAID GIS QC M&R GIS Ph JOINT USE RECEIPT N0, LOCATION MAP PAGE 455 Al SERVICE ORDER NO. FC.FNn: O EXISTING POLE X EXISTING POLE —TO BE REMOVED • NEW POLE NEW POLE TO REPLACE EXISTING POLE DATE SUBSTATION PERRINVILLE CIRCUIT NO. 12-92 PHASE 1 ENGR'S TEL. # 425 783 4355 ENGR'S CELL # 425 422 9297 3 PPG�9- `1l 8k� TO PERRINVILLE CIRCUIT 12-92 25 BEFORE & AFTER SCHEMATIC NTS OA POLE PLI # 4791 SET 50' CL 1 POLE (PW1050), 2' SW SET DEPTH = 7' INSTL (1) 3/8" PRI DG (GO113) & (1) 8" AHR, L= 12' SSW (AO101) INSTL (1) 3/8" NEUT DG TO PRI AHR (GO113) XFR EXIST 25 KVA OH XFMR (12V601) XFR OH SVCS STRIP, TOP & ABANDON 50' POLE TO COMMUNICATIONS QP OF OLD POLE NEW POLE SHEET 1 OF 1