HomeMy WebLinkAboutMFP21003613DEPARTMENT OF COMMUNITY
AND ECONOMIC DEVELOPMENT
Minor Franchise Permit: MFP21003613
IVR Number: 21003613
Permit Informaon
Permit Name:Puget Sound Energy Gas Permits
Address/Locaon :07/28/2021Application Date:0088000392Parcel Number:16474 111TH AVE SE
Permit Type:08/05/2021Issue Date:Franchise
Permit Work Class:08/05/2022Expiration Date:Minor Utility
Job Number:108630362Franchise Type:Natural Gas
Description:PSE Gas CREW TO RETIRE EXISTING GAS SERVICE AT MAIN. Restoration per City standards.
Contacts
Name Address PhoneTypeBilling
Corrie Rydberg
Puget Sound Energy
6905 S 228TH St
KENT, WA 98032
C: (253) 905-5031ApplicantX
Stacy Tucker
City of Renton
1055 S Grady Way, Fl 6
Renton, WA 98057
B: (425) -43-0-72x82Contact
Vicki Henson
Potelco Inc
8001 212th St S
Kent, WA 98032
B: (253) 863-0484Contractor
Business License Number: 5109Electrical Contractor: POTELI*344O4
Construction Contractor: POTELI*227PL
CITY OF RENTON ROW 1055 S Grady Way
Renton, WA 98057-3232
Owner
General Condions & 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.
This permit and plans must be posted at the job site at all times.
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.
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.
Call 8 1 1 to locate underground utilities at least two full business days prior to any excavation.
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.
(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
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108630632
16474 111TH AVE SE
PLEASE SEE ATTACHED
POTELCO, INC 425 892 0416
GAYLE PLAISANCE GAYLE.PLAISANCE@PSE.COM
6905 S. 228TH ST KENT, WA 98032
Monday Friday 8:00 am 3:00 pm
MFP21003613
Nathan Janders 8/5/2021
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
CORRIE RYDBERG
16474 111th Ave SE
Renton
WA 98055
USA
10 10
88SE 166TH PL111TH AVE SEW20-7A50'W20-7AROAD
WORK
AHEAD W20-1W20-4ONE LANE
ROADAHEAD
100'100'100'W20-7AROADWORKAHEADW20-1W20-4ONE LANEROADAHEAD100'100'100'STOP
FLAGGER
STOP
FLAGGER
ROADWORKAHEADW20-1W20-4ONE LANEROADAHEAD50'50'
WORK PIT
LEGEND
28" TRAFFIC CONE
SIGN LOCATION
TRAFFIC FLOW
WORK VEHICLE/
FLASHING LIGHTS
RIGHT OF WAY
SIGN SPACING
MPH
60/65
45/55
35/40
30
25
"X"
1000'
500'
350'
200'
100'
CHANNELIZATION
DEVICE SPACING
MPH
55/70
35/45
25/30
TAPER
40
30
20
TANGENT
80
60
40
TEMPORARY TRAFFIC CONTROL PLAN
N
Notes:
1. All signs and spacing to conform to the
MUTCD and City of Renton 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 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 for 111TH AVE SE will be at 71'
North of centerline of SE 166TH PL, and 14' West
of centerline of 111TH AVE SE.
Project Address:
Page
PSE PUGETSOUNDENERGY
Designer:
Job #
REV
07/16/2021
108630362
0
16474 111TH AVE SE, RENTON, WA
MATLOCK HIGHBARGER
808-375-4152
MATLOCK.HIGHBARGER@PSE.COM
1 OF 1
Puget Sound Energy
Traffic Control Supervisor:
Gregory Harwood
Card No. 012238
Card Exp. 09/30/2023
gregory.harwood@pse.com
(425)424-6425
Job #:
Date: Address:
Jurisdiction: City / Zip:
Right of Way Permit? Customer:PSE
Est. Start Date: PM / Insp:
Est. Duration:
P/L P/L
&
&
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Fuel Line Length:
Mtr Loc:Fuel Line Diameter:
Construction Method
Gravel
PLAT MAP: 212.083
Ken Elvsaas
16922 113 Ave SE
Renton, 98055
206 498 0053
888-225-5773
20
108630362
7/15/21
Renton
1 Day
Retire existing 5/8" PE complete service at main @ 71' N c/l SE 166 Place & 14' W c/l 111 Ave
SE
111 Ave SE 3x571' N of C/L SE 166 Place W of CL14'
PRE-INSPECTION REPORT
WORK DESCRIPTION:
CUST PHONE NUMBER
Work Location
PHONE NUMBER
Size of Cut Surface Type
SPEED LIMIT
MPH
Service Information
Diameter Meter EFV
N
FLAGGERS #
OFFICERS #
TROLLY LINES
TRAFFIC SIGNAL
BUS STOP #
ARTERIAL
METER HOODS #
NO PARKS #
Commercial
Residential
Multi-Family
New Constr.
Stub
Extension
Cut & Cap
Altered Commercial
Altered Residential
Replacement Service
Main Maintenance
Service Maintenance
Valve Maintenance
Leak Repair
CP Work
Pothole
Extension
Compete Serv
5/8"
11/8"
11/4"
2"
250
425
630
1000
1800
2600
10,000
Bollards 2.5" #
Bollards 4" #
FUEL LINE PERMIT NEEDED
Template Bar
YES NO
Pressure
6" WC
2#
>_ 5#
Trenchless
Open Trench
New Construct
Existing
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p 2" STW Main @ 14' W c/l111 Ave SESE 166 Place 16474OF
1000 SF Work Area
RESTORATION PER CITY OF RENTON STANDARDS
1660916611210112141121811226112221113116625164591661816606164751647116463111301645216466111161645716611111151648616474164671648347311204SE 166TH PL111TH AVE SEIdle Riser2" MPE 48'R2" MPE 76'N2" MPE IP 15'W 107027535-2007 JT2" STW IP 14'W 69E4291" STW IP 4'S 69E4295/195/8" MPEI19955/8" MPE19955/8" PE19865/8" MPE19951/2" STW-U19675/8" PE19911/2" STW-U19701/2" STW-U19695/8" MPE20035/8" PE19905/8" MPEI2007-E5/8" MPEI2007-E5/8" MPEI2007-E5/8" MPEI2007-E5/8" MPEI2007-E5/205/8" MPEI2007-E1 1/8" PE19885/8" MPEI2007-E5/8" MPEI200734'S101'S604'N154'N692'N881'N114'W100'N76'N56'N66'N90'N211'S466'N71'NEUF779'N45'S155'N122'W,4'N#C No electric grid information availableS212080, Q212083The 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).“07-13-2021Scale 1:900Lat\Long=47.454, -122.1919