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PUBLIC WORKS PERMIT Date Applied: 5/6/2022 <br /> City of Everett Permit Services Public Works Permit#: PW2205-009 <br /> 3200 Cedar Street, 2" Floor Associated Bldg Permit#: <br /> EVERETT <br /> Everett, WA 98201 Planning Reference#: <br /> WASHINGTON 425-257-8810 Public Works Fee: $209.53 <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> PUGET SOUND KIDNEY CENTERS GARRETT HOFFMAN <br /> 1019 PACIFIC AVE <br /> EVERETT,WA,98201 <br /> PHONE: PHONE:3606617605 <br /> TAX PARCEL ID#:00437572301600 SITE ADDRESS: 1019 PACIFIC AVE <br /> DESCRIPTION:TRENCH ACROSS ALLEY TO INSTALL CONDUITS/(2)BLDGS TO BE <br /> BACKED UP BY(1)GENERATOR--PLANS ATTACHED <br /> THIS PERMIT TO BE POSTED ON JOB SITE AT ALL TIMES <br /> PERMIT CONDITIONS: <br /> 1. All calls for inspection shall be made 24 hours in advance. <br /> 2. All work shall be performed in accordance with the permit and current City of Everett'Design and Construction Standards and Specifications <br /> for Development'. <br /> 3. Call Location Underground Service 48 hours before you dig.The day you call does not count.TOLL FREE NUMBER 811. <br /> 4. Site Civil Work to be done per plans approved by the City of Everett Public Works Department.Approved plans must remain on job-site at <br /> all times. <br /> 5. Inspections are required for all stages of construction.Visit the City's Online Permitting Portal at pw.everettwa.gov to formally request all <br /> required inspections.A handout is provided at permit issuance with instructions on how to request an inspection online. <br /> 6. Install and maintain erosion control measures per City of Everett Standards and per the direction of the PW Inspector and the approved <br /> SWPPP/TESC Plan. Remove upon completion of the project prior to final approval of the permit. <br /> 7. Keep City streets clean at all times. No dirt,mud,rocks,or debris to be tracked onto roadway. <br /> 8. Protect all existing underground utilities during construction. <br /> 9. Any damage to City improvements(sidewalk,curb,roadway,etc.)shall be replaced per City Standards and/or as directed by the City PW <br /> Inspector. <br /> 10. It is the applicant/owner's responsibility to ensure that stormwater runoff from new/replaced impervious surfaces will be managed on- <br /> site in a manner that does not adversely affect neighboring properties,including the City's right-of-way and/or easements and the <br /> improvements located therein. <br /> 11.This permit must be finaled in order to close out this permit. Request a final inspection online by selecting PW 25-Site Final/Permit Close <br /> Out within the Online Permitting Portal Inspection Requests for this permit when all items have been completed. <br /> 12. NOTED REVISION:This project is located within the UR4 zone.Chain link is prohibited in the UR4 zone per EMC 19.40.020.The fence <br /> material installed must be a material compliant with code.Contact the Planning Division at planning@everettwa.gov or 425-257-8731 prior to <br /> install. <br /> Public Works Permit Fee Breakdown: <br /> Cut/Bore Alley/Pavement(Non-Parallel)(18 LF)......$54.00 <br /> Paving(170SF)...........................................................$45.00 <br /> Misc. Minor Permits(Drainage Work)......................$25.00 <br /> PW Plan Review........................................................$20.00 <br /> PW Site Inspection....................................................$20.00 <br /> Stormwater System Development Fee.......................$45.53 <br /> City of Everett Official Use Only ACKNOWLEDGEMENT OF CONDITIONS <br /> By purchasing this permit and commencing work,the owner/applicant <br /> hereby agrees to hold and save harmless the City of Everett from any <br /> and all claims for damages,costs,expenses,or causes of action that <br /> n n/ may arise because of installation and maintenance of the <br /> I"WtG>'� �f'e7.wG>:l2 06/17/2022 improvement or other right-of-way use here to applied for and further <br /> agrees to remove same upon notice from the City and to replace <br /> Approved for Construction, Public Works Dept. Date public property damaged thereby. <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.THIS PERMIT MAY BE CANCELLED BY THE <br /> CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 180-DAY DURATION.EACH INSPECTION EXTENDS THE EXPIRATION DATE 180 DAYS TO KEEP THE PERMIT OPEN WHILE WORK IS ACTIVE. <br /> _APPLICANT/JOB SITE COPY _TREASURER _ADDRESS FILE <br />