HomeMy WebLinkAboutMFP21000915.pdfDEPARTMENT OF COMMUNITY
AND ECONOMIC DEVELOPMENT
Minor Franchise Permit: MFP21000915
IVR Number: 21000915
Permit Information
Permit Name: Puget Sound Energy Gas Permits
Address/Location:03/03/2021Application Date:0425000100Parcel Number: 3508 NE 10TH ST
Permit Type:03/18/2021Issue Date:Franchise
Permit Work Class:03/18/2022Expiration Date:Minor Utility
Job Number: 106374545Franchise Type:Natural Gas
Description: PSE Gas CREW TO INSTALL NEW GAS SERVICE AT MAIN, APPROX 9' IN ROW. RESTORATION PER CITY OF
RENTON STANDARDS.
Contacts
Name Address PhoneTypeBilling
Corrie Rydberg
Puget Sound Energy
6905 S 228TH St
KENT, WA 98032
C: (253) 905-5031ApplicantX
INFRASOURCE SVCS B: (206) 949-5846Contractor
Business License Number: 36742Construction Contractor: INFRASL871C2
CITY OF RENTON ROW 1055 S Grady Way
Renton, WA 98057-3232
Owner
General Conditions & Signature
Permission is hereby given for the work described on this permit according to the conditions hereon and according to the
approved plans and specifications pertaining thereto, subject to compliance with the Ordinance of the City of Renton.
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This permit and plans must be posted at the job site at all times.Ÿ
I hereby certify that no work is to be done except as described above and in approved plans, and that work is to conform to
Renton Trench Restoration and Street Overlay Requirements.
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Call 425.430.7203 or go to: https://permitting.rentonwa.gov one working day in advance to schedule an inspections and for ANY
work in the Right of Way.
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Call 8 1 1 to locate underground utilities at least two full business days prior to any excavation.Ÿ
In accordance with RCW 19.122.033(4) the permit holder is required to contact (Williams Northwest Pipeline at 425.868.1010)
(Olympic Pipeline at 206.510.0575) (Puget Sound Energy at 425.375.3397) to request a consultation with the transmission
pipeline company prior to performing any construction or excavation activities. This requirement to consult with the
transmission pipeline company is in addition to the requirement to Call before You Dig as required in RCW 19.122.
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(Date)(Signature)
Page 1 of 1THIS PERMIT AND PLANS MUST BE POSTED AT THE JOB SITE AT ALL TIMES
DEPARTMENT OF PUBLIC WORKS
Note: The Applicant is responsible for compliance with all codes and regulations, whether or not described in this document.
Page 1 of 2 | Published: 1ϭ/Ϯϱ/2019
Transportation Division | 1055 South Grady Way, 5th Floor | Renton, WA 98057 | 425-430-7380
Website: rentonwa.gov
TRAFFIC CONTROL PLAN (TCP) APPLICATION
Published: 1ϭ/Ϯϱ/2019
TRAFFIC CONTROL PLAN (TCP) MUST BE SUBMITTED TO PUBLIC WORKS TRANSPORTATION DIVISION
FOR REVIEW/APPROVAL NO LATER THAN FIVE (5) WORKING DAYS BEFORE THE DATE OF WORK.
The City of Renton requires any contractor, firm, corporation, or other public/private agency to prepare a TCP and
obtain City of Renton's approval of that plan when construction, repair, or maintenance work is to be conducted
within the city's right-of-way.
TO THE APPLICANT: Submit the TCP application form and required submittal documents to
TCP@rentonwa.gov with the subject line “TCP Application – [Project Name]” or the above address.
The following items, electronic copies preferred, are all required for submittal of the TCP Application:
1.܆ A copy of the Traffic Control Plan (TCP) Application form.
2.܆ A copy of the required TCP layout, preferred 11” X 17” paper size format, which shall:
܆ Include map(s) showing the location of the project and work area.
܆ Be legible lettering and clear, contrasting, symbols of viewing or printing.
܆ Must indicate street names, and north arrow and scale.
܆ All signs and detour routes shall conform to the MUTCD, WSDOT TCPs, and the Washington State
Traffic Control Flagger Certification handbook, by the Evergreen Safety Council.
܆ Types of plans required:
܆ Work hour plan – show all mobility impacts during construction hours.
܆ Non-work plan - show all mobility impacts after work hours when limited or no work is
happening in the right-of-way (ROW), if applicable.
܆ Changing construction phases – show construction sequence and each construction phase
change even if the traffic control is not modified, if applicable.
܆ Pedestrian access/detour plan, if applicable.
Project Name: ______________________________________________ Permit #: _____________________
Project Address: ____________________________________________________________________________
Work Date: From _____________ To _____________ Work Time: Start ______________ End ______________
Description of Work, Work Schedule, Equipment Used: _____________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
Construction Company: ________________________________________ Phone/Cell: (_____) _____-________
Applicant Name: _________________________________ Email: ______________________________________
Business Address: _________________________________ City/State: __________________ Zip: __________
Approved By: _______________________________________________ Date: ________________________
Transportation Operations Engineering
MFP21000915
Scott Warlick CED 3/18/2021
Note: The Applicant is responsible for compliance with all codes and regulations, whether or not described in this document.
Page 2 of 2 | Published: 1ϭ/Ϯϱ/2019
APPLICANT AGREES TO ALL THE FOLLOWING:
x TCP must be approved prior to commencing the work, and all permit conditions shall be met.
x Existing pedestrian access shall be maintained. The work on pedestrian facilities shall be limited to one corner
at a time, with the least possible inconvenience or delay to pedestrians.
x Signage shall be used to warn motorcyclists/bicyclists of the potential hazards on any uneven surfaced or
slippery road conditions during work and non-work hours.
x The start of Work Time begins when any street or travel lane is fully/partially closed or impacts the follow of
traffic. This includes set up within the traveled way or immediately adjacent to the roadway.
x Emergency services (253-852-2121) shall be notified twenty-four (24) hours before any street or lane closures.
x Contractor or entity must call Renton School District (425-204-4455) or any public/private agency, including
public transit, to be affected by a temporary lane or road closure.
x TCP for all street and/or lane closures shall be implemented and performed in compliance with the Manual on
Uniform Traffic Control Devices (MUTCD) and/or State of Washington Department of Transportation (WSDOT)
and all traffic regulations of the City of Renton and Revised Code of Washington (RCW).
x Any lane or street closures not in conformance with the approved traffic control plan and/or without
notification of emergency services may result in receiving a citation for violation of RCW 47.36.200 Signs or
Flaggers at thoroughfare work sites and RCW 9A.36.050 Reckless Endangerment, and other applicable State
and City codes.
x Indemnify and hold harmless the City of Renton from any and all claims, actions, and judgments, including all
costs of defense and attorney’s fees incurred in defending against same, arising from and related to
implementation of the approved traffic control plans including claims arising from towing of private vehicles
and the acts of the Applicant’s agents and employees.
x The City of Renton shall be entitled, in its reasonable discretion, to settle claims prior to suit or judgment, and
in such event shall indemnify and hold harmless the City for any such claims paid, including the City’s
reasonable attorney’s fees and litigation costs incurred resulting from such claim.
x In the event any claim or suit is brought against the City within the scope of this Agreement, Applicant will pay
for legal counsel chosen by the City to defend against same.
x Flagger and sign placement are subject to revision by the City Inspector on site, if needed to address traffic or
pedestrian safety or travel.
x Total road closure lasting more than twenty-four (24) hours is subject to the approval by the City Council.
x Approved Temporary TCP must be at the work site during work hours.
x Complete assistance and accommodation shall be provided to all kinds of pedestrian traffic when sidewalk or
walkway is impeded to safely redirect pedestrians around a work zone.
x Any vehicle, equipment, barricade, or portable tow-away sign used within the work area must display a
company logo or any legally acceptable sign showing the company name, address, and telephone number at a
conspicuous place on the vehicle or equipment.
In the case of Temporary No Parking Zones, all the following apply in addition to previous:
x Contractor must complete form to show limits of Temporary No Parking Zone identifying barricade locations
for vacate parking or curb lane usage.
x Contractor must post notice of dates and time of Temporary No Parking Zone with at least two signs per block
seventy-two (72) hours in advance of effective date and time.
x The cover sheet of this TCP form must be attached to each Temporary No Parking Sign on the project site.
x Temporary traffic control devices must be removed immediately when work is done or no construction
activities are going on. If deemed abandoned, City crews will remove and store them at the City’s maintenance
shop (3555 NE 2nd Street; 425-430-7423).
_______________________________ _______________________________ _______________________
Applicant’s Signature Print Name Date
181818 18121212121818NE 10TH STOLYMPIA AVE NEOLYMPIA AVE NENE 10TH ST3508SHOULDER
WORK W21-5ROAD
WORK
AHEAD W20-1100'100'ROADWORKAHEADW20-1100'RESIDENT(S) WILL BE INFORMEDOF POSSIBLE TEMPORARYDRIVEWAY CLOSUREPLACE SIGNSBOTH SIDES OFWORK AREAFROMTOTOW AWAY AREAPHONE 888-9999INFRASOURCE LLC 000 0000000NO PARKINGNO-PARK
FROM TO
TOW AWAY AREA
PHONE 888-9999
INFRASOURCE LLC 000 0000000
NO PARKING
NO-PARK Puget Sound EnergyTraffic Control Supervisor:Gregory HarwoodCard No. 012238Card Exp. 09/30/2023gregory.harwood@pse.com(425)424-6425TEMPORARY TRAFFIC CONTROL PLANNotes:1. All signs and spacing to conform to theMUTCD and King County standards.2. All sidewalks, driveways, exits and egressesshall be completely clear unless otherwise indicated.3. Channelizing devices are 28" traffic cones.Use traffic drums (barrels) with steady burningType C lights on all State State Routes and Hwys.4. Sign size can be a minimum of 36" x 36" andshall not obstruct pedestrian access.5. Crew is required to leave a minimum of 11' fortraveling lane width.6. Alert affected residents and businesses.7. Work to take place between 9 a.m. and 4 p.munless otherwise specified. All work for arterialsand major roadways will be from 9 a.m. to 3 p.m.8. Work area will be 20' NCL of NE 10th St & 225'WCL of Olympia Ave NE.NWORK PITLEGEND28" TRAFFIC CONESIGN LOCATIONTRAFFIC FLOWWORK VEHICLE/FLASHING LIGHTSRIGHT OF WAYSIGN SPACINGMPH60/6545/5535/403025"X"1000'500'350'200'100'CHANNELIZATIONDEVICE SPACINGMPH55/7035/4525/30TAPER403020TANGENT806040PSEPUGETSOUNDENERGYJOB#1063745453508 NE 10th St, Renton, WAMarch - 02 - 2021ina.ustemchuk@pse.com(425)398-6063SHEET 1 of 1MFP21000915
Est. Start Date:
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&
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Job #:106374545
Date:3/1/21 Address:3508 NE 10TH ST
Puget Sound Energy Gas Pre-Inspect Form
3/22/21 PM / Inspector:SHANNON MOORE 206-681-7086
Est. Duration:1 Day (8 Hours)
Jurisdiction:RENTON City / Zip:RENTON, 98056
ROW Permit:Yes Customer:BRIAN HAWKS (425) 443-0194
PLAT Map:206.085
N
Work Location Size of Cut Surface Type
Job Description / Scope of Work
TIE INTO 1-1/4" PE SVC INSTALL 40' 1-1/8" PE SVC (9' SCAT STUB, 31' PLAT EXT) SET A425 MSA. New Construction:
No
Construction Method
Scat ROW / Plat Property
of CL OLYMPIA AVE NE 3X5 ASPHALT
of CL
20'NORTH of CL NE 10TH ST 225'WEST
of CL
Service Information Street Information Job Type
of CL
of CL
Residential Conversion SVC
EFV:0 Police #:TCP:YES
Diameter:1-1/8" PE Flaggers #:Arterial:NO
Trolley Lines:NO Mtr Hoods #:
Meter:A425 Speed Limit:HDPE - 1 - 1/4" IPS - (DIA) 1"CTS
Tie-In Fitting
Route #'s:Bollards:2.5" #4" #ADA Ramps #:
Del Press:6" W.C.Traffic Signal:NO Bus Stop:NO
25 No Parks #:
Meter Loc:08 - OR
WROW 60 FT1-1/4" PEI 20'N 842090
S
MFP21000915
RESTORATION PER CITY OF RENTON STANDARDS
1002351910061010101410211017101310091003871352735103508351135001008350334093412913903100435173509350191035003506351235181012100710063526362536313518360236103524351636083616362435253533360136253633361736093641361836123606360035243630362436263618360335353611361936273600363236353401340534063400NE 9TH STNE 9TH STNE 10TH LNNE 10TH STNE 10TH STOLYMPIA AVE NEOLYMPIA AVE NE
No electric grid information availableS204080, Q206085The information on the attached maps is subject to change without notice. Puget Sound Energy makes no warranty, expressed or implied, concerningthe suitability of this information for any purpose. Recipient agrees to not disclose this confidential information to any other person or entity,unless authorized in writing by Puget Sound Energy. This map is not to be used for determining the actual location of any PSE facilities (call 811).“03-01-2021Scale 1:1012Lat\Long=47.4986, -122.1717MFP21000915