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PUBLIC WORKS PERMIT <br />Date Applied: <br />3/13/2023 <br />City of Everett Permit Services <br />Public Works Pei#: <br />131%12303-006 <br />3200 Cedar street, 2.d Floor <br />Associated Bldg Permit#: <br />EVERETTEverett, <br />WA 98201 <br />Planning Reference #: <br />everettwa.Rov/permits <br />Public Works Fee: <br />$187.22 <br />WASHINGTON <br />Perm USA ryices0eyerettwa. gay <br />Schedule Inspections at onllneoermits.everettwa.eov <br />OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br />HELGESON DAVID A & SHARI K DAVE HELGESON <br />1832 RUCKER AVE <br />EVERETT, WA 98201 <br />PHONE: PHONE:4253207007 <br />SITE ADDRESS: U32 RUCKER AVE TAX PARCEL ID #: M37437101700 <br />THIS PERMIT TO BE POSTED ON JOB SITE AT ALL TIMES <br />DESCRIPTION: LEVEL GRADE IS, CONSTRUCT 1955E CEMENT PATIO IN BACKYARD <br />PERMIT CONDITIONS: <br />1. All inspections shall he scheduled online at hi//onlineoermitseverettwaeov. Available inspection dates are shown in the radia con menu. <br />2. All work shall be performed in accordance with the permit and current Clty of Everett 'Design and Construction Standards and Spsufcatlons for <br />Development. <br />3. Call Loddrn Underground Service 48 hours before you die. The day you call does not count TOLL FREE NUMBER 811. <br />4. Site Clvll Work to he done per plans approved bythe City of Everett Public Works Department. Approved plans must remain onjobsite at all times. <br />5. Inspectons are required for all stages of construction. Visit the City's Online Permitting Portal at oniinepermits.evereUwa.gov to formally request <br />all required inspeclions. <br />6. Install and maintain erosion control measures per (my of Everett Standards and per the direction of the PW Inspector and the approved <br />SWPPP/TESC Plan. Remove upon completion Of the project pdorto final approval of the Permit. <br />T. Keep Citystreets clean at all times. No dirt, mud, rocks, or debris to he tracked onto roadway. <br />S. Protect all existing underground uBlities during construction. <br />9. Any damageto any improvements (sidewalk,curb, roadway, efc.) shall be replaced per City Standards and/or as directed bythe City PW Inspector. <br />30. It isthe applicant/owners responsibllinytu ensure that stormwater runoff from new/replaced impervious surfaces will be managed onsite in a <br />mannerthatchoes not adversely affect neighboring properties, includingthe Chys right of and/or easements and the improvements located <br />therein. <br />11. Fri any interruption to the public right-of-way lmadways, parking lanes, or sidewalksl a Traffic Street Use permit shall be obtained from the <br />Chy sTraffic Engineering Division. This permit can be applied for online at onllnepermits.everellwa.gov and requires a traffic control plan to be <br />submitted for the area of requested Clasure. Please allow 1-2 weeks for TSU permit Issuance from the date of application. <br />II. This permit must be fnaled In order to close out this permNgrarh a CertiOcate of Occupancy .Request afinal inspection online byselectingPIN 25- <br />Site Final/Permit Close Out within the Online Permitting Portal Imported Requests for this remain when all items have been completed. <br />PERMIT FEE BREAKDOWN: <br />Erosion Control .... ........................................................................ <br />$50.00 <br />Paving(195 SF) .............................................................................$45.00 <br />PW Plan Review ..................... ..._.... ..... .... ..... ............................. <br />$20.00 <br />PW She Inspection ................. ..... .... .......... ..... .............................. <br />$20.00 <br />Stormwater System Development Fee (195 SH.......................... <br />$52 22 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />By purchadin this permit and commencing work, the owner/applicant hereby agrees to hold and save worries; the City of Everett from any and <br />all claims for damages, costs, expenses, or causes of action that may arise because of Installation and maintenance of the Improvement or what <br />right-of-way use here to applied for and further agrees to remove some upon notice from the City and to replace public property damaged <br />thereby. <br />VALIDITY/EXPIRATION <br />Work authorized by this permit must be started within 180 days of date permit is issued and thereafter is to be diligently pursued to completion. <br />This permit may be canceled by the city upon any stoppage of work on this project over 180-tlay duration. Each inspection extends the expiration <br />date 18D days to keep the permit open while work is active. <br />Page 1 of 1 <br />_APPUKANT/IOB SRE COPY _ADDRESS FILE _TREASURER <br />