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PUBLIC WORKS PERMIT Date Applied: 9/1/2021 <br /> City of Everett Permit Services Public Works Permit#: PW2109-002 <br /> 3200 Cedar Street, 2"d Floor Associated Bldg Permit#: <br /> EVERETT <br /> Everett, WA 98201 Planning Reference#: <br /> WASHINGTON 425-257-8810 Public Works Fee: $65.00 <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> VAN WINKLE DAVID S& DEBBIE G ANTHONY FREEZE <br /> 2816 ROCKEFELLER 19330 WINESAP RD#24 <br /> EVERETT,WA,98201 BOTHELL,WA,98012 <br /> PHONE:4252599288 PHONE:4253182660 <br /> TAX PARCEL ID#:00439166601900 SITE ADDRESS: 2816 ROCKEFELLER AVE <br /> DESCRIPTION:TUCKPOINT TO REPAIR ERODED MORTAR ON FACE AND REAR OF BLDG <br /> GRIND AND REPLACE HALF INCH OF EROTED MORTAR NOT STRUCTURAL, PART OF THE SIDEWALK NEEDS TO BE CLOSED TO HAVE AN <br /> AREA OF WORK. <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. Traffic Control must be done in accordance with MUTCD Standards and the Traffic Control Plan approved (as noted)by City of Everett <br /> dated 09/01/2021. <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. Flyers are provided at permit issuance with instructions on how to request an inspection online.6. Any damage to City <br /> improvements(sidewalk,curb,roadway,etc.)shall be replaced per City Standards and/or as directed by the City PW Inspector. <br /> 7. All existing underground utilities must be located and protected throughout the duration of project if any cuts are anticipated. <br /> 8. It is the owner/applicant's responsibility to ensure the safety of pedestrians and workers is maintained and any damage to surrounding <br /> structures,vehicles,etc.associated with the scope of this permit is the sole responsibility of the owner/applicant.The City makes no claim to <br /> the reliability of the scaffolding structure being erected. <br /> 9.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 /> Public Works Permit Fee Breakdown: <br /> Misc. Minor Permits(Scaffolding in R.O.W.)..........$25.00 <br /> PW Plan Review......................................................$20.00 <br /> PW Site Inspection.................................................$20.00 <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 /> may arise because of installation and maintenance the <br /> 09/07/2027 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 />