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Home My WebLink About430 N West Ave_PWD2673_2026 Permit#: 2673 Permit Date: 08/12/21 Permit Type: GRADING Project Nam e Autum nvood Properties Paving Applicant Nam a Bakhtiar Ardi Pribadi Applicant Address: 430 N. West Ave Ste. 1 Applicant, City, State, Zip: Arlington,WA98223 Contact Person: Bakhtiar Pribadi Phone: 415-601-0095 Em ail: dr_pribadi@autum rivooddental.com Scope of Work: Repaving and redevelopm ant of parking lot and adding 2 catch basins Valuation: 34067.81 Project#:: ID Code: CED Permit Issued: 08/25/2021 Permit Expires: 02/21/2022 Status: COMPLETE Assigned To: Raelynn Jones Property Parcel# Address L egal Description O wner Nam e Omer Phone Zoning 00618100500100 4 30 N WEST AVE A UTUMNWOOD 699 Other PROPERTIES LLC Miscellaneous Services NEC Contractors Contractor P rim ay Contact P hone A ddress C ontractor Type L icense License# Fidalgo Paving& 360-652-2380 1 6825 45 Road C onstruction Contractor labor&Industries FIDALPC946BK Construction 08/19/202108/19/202108/19/202108/19/202112/13/202112/13/2021 Plan Reviews Date Review Type D escription A ssigned To T arget Date 08/12/2021 GRADING C ED INSPECTOR 08/19/2021 08/12/2021 GRADING I nstall Oil water separators in both CB's per detail. N ova Heaton 08/19/2021 08/12/2021 G RADING P WSTORM REV 0 8/19/2021 08/12/2021 G RADING N o Com m nts P LANNING 0 8/19/2021 11/29/2021 A S-BUILT N ova Heaton 1 2/13/2021 11/29/2021 A S-BUILT C ED INSPECTOR 1 2/13/2021 Fees Fee D escription N otes A m curt Processing/Technology $25.00 Civil Perm 1 $2,044.07 Credit Card Service $62.07 Total $2,131.14 Paym efts Date Paid By D escription P aym art Type A ccepted By A m aunt 08/23/2021 Bakhtiar Pribadi 8 8136915 $2,069.07 08/23/2021 88136915 R aelynn Jones $62.07 O itstanding Balance $0.00 Notes Date Note C reated By: 11/29/2021 Routed applicants as-built response to Nova/Brian via em al R aelynn Jones 11/24/2021 Sent follow up em dl for project closeout letter R aelynn Jones 11/02/2021 Sent Project closeout letter to applicant R aelynn Jones 10/28/2021 All punchlist item sapproved per BG. R aelynn Jones 08/12/2021 Em dled contractor for business license R aelynn Jones Uploaded Files Date File Nam e 08/12/2021 9460493-8-11 Autum nvood site plan.pdf 08/12/2021 9460492-8-11 Autum rood invoice.pdf 08/12/2021 9460491-8-11 Autum rood Application.pdf 08/12/2021 9460490-8-11 Autum rood CCWxlsx CONSTRUCTION PERMIT APPLICATION Community&Economic Development City of Arlington • 18204 5911,Avenue NE • Arlington,WA 98223 • Phone(360)403-3551 CIVIL(TYPE I) GRADING/PAVING/DRAINAGE(TYPE II) O RIGHT OF WAY(TYPE III) O TYPE I&II ONLY NEW DEVELOPMENT REDEVELOPMENT Project Name: Autumnwood Properties Lot Repaving 00618100500100 Snohomish County Tax Parcel I.D. #: Project Address/Location: 430 N. West Ave, Arlington, WA, 98223 Description of Project: Parking Lot Repaving and redevelopment of 2 catch basins OWNER Bakhtiar Ardi Pribadi Name: Address: 430 N. West Ave Ste 1 city:Arlington State: WA Zip-98223 Phone: 4156010095 Eiiiail:dr—pribadi@autumnwooddental.com APPLICANT Name: see above Address: see above City: see above State:see above Zi :98223 Phone:see above Email: see above ENGINEER Name: n/a Address: n/a City: n/a State:n/a Zip- n/a Phone: n/a Email: n/a License #: n/a Expiration: n/a CONTRACTOR Name: Fidalgo Paving Address: 16825 45th Rd Arlington State:WA Zip- 98223 Phone:2062276410 Email:office@fidaIgopaving.com License #: n/a Ex iration:n/a 1, hereby certify that 1 have read and examined this application, City of Arlington Municipal Code, Standard Plan & Specifications. Performance of the proposed work shall follow all applicable laws and regulations.The owner/applicant shall assume full and complete responsibility for said work and shall be responsible for the acquisition and compliance of all applicable permits and/or authorizations which may include,but not limited to,Right of Way Permit,WSDW Hvdrav�ena ►6,p^MvaIWSDOE Notice of Intent(NOI),National Pollutant Discharge Elimination System (NPDES),Army Corp.of Engineers Per red Species Act and the Forest Practices Application(FPA). Signature Kay:...........��«......... Print Name: Bakhtiar A Pribadi Date: 08/10/2021 Pagel of 2 REV 11/2018 Complete package constitutes all items. Only complete submittals will be accepted. Civil-Submittal Requirements,Type I: ❑ Complete Application; ❑ Construction Plans including cut/fill quantities; ■ 2 fill size plan sets 2 2"x 34" ■ PDF file of the complete plan set ■ 2 fill size set of landscape plans 2 2"x 34" ❑ Marysville Utility plans,if applicable(2 sets); ❑ Drainage Analysis including calculations and downstream analysis (2 sets)and(PDF file);refer to Stormwater Drainage Requirements; ❑ Geotechnical Report(2 sets) and(PDF file); ❑ SEPA is required if 500 or more cubic yards of cut/fill is proposed(not required if included with a Land Use Permit); ❑ Grading cut/fill quantity: , ❑ Design Vehicle-demonstrate turning radius include 45'Fire trunk,dual axle, 256 inch wheel base; ❑ Complete Streets Checklistn/a ❑ Drafts of easement(s) dedication(s),and/or CAPE(s) for review; ❑ Flood Hazard Permit Application and required documentation if project is within 100 year flood plain;refer to Flood Hazard guidance documents; ❑ Construction Calculation Worksheet; ❑ NPDES Permit(if required);See Storm Water Drainage Report,New or Redevelopment Flowcharts; ❑ Assurance Device will be required prior to Permit Issuance (Bond or Assignment of Funds); ❑ Permit Fee due at tine of permit submittal. Grading I Paving I Drainage Submittal Requirements.Type II: ❑ Complete Application; ❑ Construction Plans including import/export quantities; ■ 2 fill size plan sets 2 2"x 34" ■ PDF file of the complete plan set ❑ Drainage Analysis including calculations and downstream analysis (2 sets)and(PDF file);refer to Stormwater Drainage Requirements; ❑ Geotechnical Report(2 sets) and(PDF file); ❑ SEPA is required if 500 or more cubic yards of cut/fill is proposed(not required if included with a Land Use Permit); ❑ Grading cut/fill quantity:see Fida Igo ❑ Construction Calculation Worksheet; ❑ NPDES Permit(if required);See Storm Water Drainage Report,New or Redevelopment Flowcharts; ❑ Permit fee due at time of permit submittal. Right of Way Submittal Requirements.Type III: ❑ Complete Application; ❑ Construction Plans; ❑ Traffic Control Plan; ❑ Road Closure Request; ❑ Temporary Erosion&Sediment Control(TESL) Plan; ❑ Certificate of Insurance with the City of Arlington named as Additional Insured; ❑ Assurance Device will be required prior to Permit Issuance(Bond or Assignment of Funds); ❑ Engineers Estimated Cost of Construction;$ n/a ❑ Permit fee due at time of permit issuance. Page 2 of 2 ESTIMATE/CONTRACT AGREEMENT PAVING & CONSTRUCTION, LLC. 16825 45 ROAD-ARLINGTON,WA 98223 LICENSED,BONDED AND INSURED � " ON PH:360-652-2380 FAX:360-652-2480 "AN EQUAL OPPORTUNITY EMPLOYER" Nm EMAIL: office@fidalgopaving.com MEMBER FP&C JOB## DATE: 6/22 f 2020 d Ki,J S,, ---h I.-r.., CONTRACTING PARTY: LOCATION&TYPE OF WORK: AUTUMNWOOD PROPERTIES AUTUMNWOOD DENTAL ATTN:ARDI PRIBADI 430 N.WEST AVE 430 N.WEST AVE,STE#1 ARLINGTON,WA 98223 ARLINGTON,WA 98223 (OFF) (415) 601-0095 (CELL) FAX dr pribadi@autumnwooddental.com EMAIL APPROXIMATE UNIT DESCRIPTION UNIT QUANTITY PRICE. PARKING LOT 9,100 SF REMOVE&REPLACE THE ENTIRE APSHALT PARKING LOT WITH 2" OF LUMP SUM $21,000.00 ASPHALT COMPACTED 1 EACH INSTALL ASPHALT RAMP LUMP SUM $350.00 1 EACH INSTALL TYPE 1 CATCH BASIN 60 LF OF 8"PIPE. LUMP SUM $4,500.00 LAYOUT AND STRIPE THE PARKING LOT LUMP SUM $700.00 SUBJECT TO THE TERMS AND CONDITIONS ON REVERSE SIDE(PAGE 2) CLARIFICATIONS: 1). PRICE IS BASED ON WORK BEING DONE DURING NORMAL WORKDAY HOURS. 2). WASHINGTON STATE RETAIL SALES TAX IS NOT INCLUDED. APPLICABLE SALES TAX WILL BE ADDED TO THE INVOICED AMOUNT UNLESS A CURRENT R£SELLER PERMIT IS ON FILE WITH FIDALGO PAVING&CONSTRUCTION,LLC. 3). ACKNOWLEDGE ADDENDUM(S): EXCLUSIONS: ALL ITEMS NOT SPECIFIED ABOVE,INCLUDING,BUT NOT LIMITED TO: ENGINEERING,TRAFFIC CONTROL,PERMITS,GRINDING,SURVEY,AND MATERIAL TRANSFER DEVICE/VEHICLE(MTD/V). *IF YOU WOULD LIKE TO PROCEED WITH THE PERFORMANCE OF THIS WORK,PLEASE SIGN BELOW AND ON PAGE 3-"NOTICE TO CUSTOMER"AND RETURN BOTH PAGES TO OUR OFFICE VIA FAX,EMAIL OR REGULAR MAIL. ONCE RECEIVED,WE WILL CONSIDER THIS A LEGAL AND BINDING CONTRACT AGREEMENT FOR THE PERFORMANCE OF THE HEREINABOVE WORK. "YOUR SIGNATURE BELOW ALSO ACKNOWLEDGES RECEIPT OF OUR"NOTICE TO CUSTOMER"STATEMENT AS PRINTED ON PAGE 3 OF THIS ESTIMATE/CONTRACT AGREEMENT" CONTRACTING PARTY'S AUTHORIZED REPRESENTATIVE: FIDALGO PAVI CONSTRUCTION,LLC. WASHINGTON R,ACFOR'S LICENSE NO.FIDALPC946BK i S.Ardi Pribadi DDS Digitally signed by ACCEPTED BY: PRIBADI.BAKHTIAR.A.1289659915 BY: DIT EMS,03LIM GU70ffMnt, PRINTED NAME: ou=DoD,ou=PKI,ou=USAF, IEFE ON (2061227-6410(CELL) c n=PRI BADI.8 AKHTIAR.A.1289659 915 Date:2020.09.03 07:56:15.0700' FIDALGO PAVING &CONSTRUCTION, LLC. CONTRACT AGREEMENT NOTICE TO CUSTOMER NOTICE TO Cl'STO.ME,R Business Name: Fidaleo Paviniz& Construction. LLC. This contractor is registered with the State of Washington, license No. FIDALPC946BK, and has posted with the state a bond of Twelve Thousand Dollars ($12,000.00) for the purpose of satisfying claims against the contractor for breach of contract including negligent or improper work in the conduct of the contractor's business. The expiration date of this contractor's license is 01;12/2022. THIS BOND MIGHT NOT BE SUFFICIENT TO COVER A CLAIM THAT MIGHT ARISE FROM THE WORK DONE UNDER YOUR CONTRACT. This bond or deposit is not for your exclusive use because it covers all work performed by this contractor. The bond or deposit is intended to pay valid claims up to Twelve Thousand Dollars ($12,000.00) that you and other customers, suppliers, subcontractors, or taxing authorities may have. FOR GREATER PROTECTION YOU MAY WITHHOLD A PERCENTAGE OF YOUR CONTRACT. You may withhold a contractually defined percentage of your construction contract as retainage for a stated period of time to provide protection to you and help insure that your project «ill be completed as required by your contract. YOUR PROPERTY MAY BE LIENED. If a supplier of materials used in your construction project or an employee or subcontractor of your contractor or subcontractors is not paid, your property may be liened to force payment and you could pay twice for the same work. FOR ADDITIONAL PROTECTION, YOU MAY REQUEST THE CONTRACTOR TO PROVIDE YOU WITH ORIGINAL "LIEN RELEASE" DOCUMENTS FROM EACH SUPPLIER OR SUBCONTRACTOR ON YOUR PROJECT. The contractor is required to provide you with further information about lien release documents if you request it. General information is also available from the state Department of Labor and Industries. THIS;NOTICE IS GIVEN PURSUANT TO RCW 18.27.114 .Acknowleduement of Receipt of Notice to Customer: Digitally signed by FRIRADI,RAKHTIAR A 1269659 915 03SEP2020 DN-US,o=US Government Dated: uu-D9D 9u-P10.-USAF crt=PFIDAERHARHTIAR A 1289 654915 Date 202009 03 07 57 37 .0700 Signature of Customer(Contracting Party) PAGE 3OF3 107 506 107 � I r 3 z •� W Sth St W Sth St W 5th St W Sth St . N" W 5th St EXIT.CB _ 430 NW Ave, � "'• - e Z' Arlington,Wf 98223 * 1 � yF- �• .r 110 i12 1^ N OI Arlington Inspire Hair Studio I I I Laundry Station and Creative Designs �i NEW CB � • 1 • ram.► 111 "e Licensing yI Yard Drain i `II (replace)❑1 =s •_M- OI9K- 1wn r �•' T _ AZ�Tran Transmissi Google Y �� CONTRUCTION PLAN REVIEW & INSPECTION FEE WORKSHEET ��lINGS�� Community&Economic Development Department City of Arlington . 18204 59th Avenue NE . Arlington WA 98223 . (360)403-3551 This form is to be completed and submitted with Type I , Type 11 Type III Construction Permit Application. 1) Based on permit type requested (Type I,Type II or Type III), complete the form as follows: . Type I permits complete all sections. . Type 11 permits complete as follows: - Grading Only-Complete Temporary Erosion and Sediment Control (TESC). - Stormwater Drainage Only-Complete the Temporary Erosion and Sediment Control and Stormwater Drainage Section for Public or Private . Type III permits complete the Temporary Erosion and Sediment Control (TESC). 2) The developer shall enter the quantities shown on the construction drawings into the Construction Calculation Worksheet. This document is used to determine the amount of plan reivew and inspection fees due to the city. 3) Excel will auto-calculate the relevant fields and subtotals throughout the document. Only the'Quantity'columns should be completed. 4) The summary page calculates the fees due at intake for Civil and Stormwater Drainage construction permits only. This does not include fees for Grading or those required by other departments or agencies. Grading fees are based on Cubic Yard Quantity and shall be calculated at time of permit submittal. Grading fees shall be paid at permit submittal. 5) If an item that is part of your project does not exist in the spreadsheet complete the Write-In-Items section with the item, quantity and associated unit cost. There are a few unit prices that are blank, please complete them accordingly. 6) Inspection fees shall be calculated for Private Development during the review process and shall be paid upon permit issuance. PROJECT COSTS PUBLIC TOTAL PRIVATE TOTAL TOTAL PROJECT COST $ 34,067.81 Verify formula, totals do not match PLAN REVIEW& INSPECTION FEES PLAN REVIEW&INSPECTION FEE (6%of Project Value) $ GRADING FEE(4) (Cubic Yard ) $ Review fees due at time of submittal Total Review Fees Due $ An Assurance Device such as a Performance Bond or Assignment of Funds needs to be on file with the City of Arlington prior to permit issuance. The Assurance Device shall be 150% of the Construction Calculation Worksheet which are as follows: Road and Alley (Public) Stormwater Drainage and Grading (Public) Utilities (Public) Temporary Erosion and Sediment Control (Public and Private) ASSURANCE DEVICE Base Calculation of Performance Device $ PERFORMANCE DEVICE 150% Amount Due $ Base Calculation of Maintenance Device $ MAINTENANCE DEVICE 20% Amount Due $ - 1 Rev 7/2017 CONSTRUCTION CALCULATION WORKSHEET TEMPORARY EROSION &SEDIMENT CONTROL Include Public Improvements &Private Development Description Unit Price Unit Quantity Cost Reference# Backfill &compaction-embankment $ 6.50 CY $ - Check dams $ 78.00 EACH $ - BMP C207 Catch Basin Protection $ 35.50 EACH $ - Crushed surfacing 1 1/4" minus $ 18.00 TON $ - WSDOT 9-03.9(3) Ditching $ 8.00 CY $ - Excavation-bulk $ 3.00 CY $ - Fence, silt $ 2.00 LF $ - BMP C233 Fence,Temporary(NGPA) $ 2.00 LF $ - Geotextile Fabric $ 2.50 SY $ - Hay Bale Silt Trap $ 0.50 EACH $ - Hydroseeding $ 4,200.00 ACRE $ - BMP C120 Interceptor Swale/Dike $ 1.00 LF $ - Jute Mesh $ 2.00 SY $ - BMP C122 Level Spreader $ 1.75 LF $ - Mulch, by hand, straw, 3"deep $ 3.00 SY $ - BMP C121 Mulch, by machine, straw, 2"deep $ 1.00 SY $ - BMP C121 Piping,temporary, CPP, 6" $ 12.50 LF $ - Piping,temporary, CPP, 8" $ 19.00 LF $ - Piping,temporary, CPP, 12" $ 24.00 LF $ - Plastic covering, 6mm thick, sandbagged $ 3.00 SY $ - BMP C123 Rip Rap, machine placed; slopes $ 50.00 CY $ - WSDOT 9-13.1(2) Rock Construction Entrance, 50'xl5'xl' $ 1,800.00 EACH $ - BMP C105 Rock Construction Entrance, 100'xl5'xl' $ 3,600.00 EACH $ - BMP C105 Sediment pond riser assembly $ 3,050.00 EACH $ - BMP C241 Sediment trap, 5' high berm $ 21.00 LF $ - BMP C240 Sed.trap, 5'high, riprapped spillway berm section $ 79.00 LF $ - BMP C240 Seeding, by hand $ 1.00 SY $ - BMP C120 Sodding, 1"deep, level ground $ 8.00 SY $ - BMP C120 Sodding, 1"deep, sloped ground $ 9.50 SY $ - BMP C120 TESC Supervisor $ 84.00 HR $ - Water truck, dust control $ 130.00 HR $ - BMP C140 WRITE-IN-ITEMS SUBTOTAL(TESC Only): $ - MOBILIZATION 10%: $ - CONTINGENCY 15%: $ - TOTAL: $ - Rev 7/2017 CONSTRUCTION CALCULATION WORKSHEET STORMWATER DRAINAGE Public Private Public Improvements Private Development Description Unit Price Unit Quantity Cost Quantity Cost Access Road, Retention/Detention $ 26.00 SY $ - $ - *(CBs include frame and lid) Beehive $ 90.00 EACH $ - $ - CB Type 1 $ 1,650.00 EACH $ - 1 $ 1,650.00 CB Type IL $ 1,850.00 EACH $ - $ - CB Type 11,48" Dia $ 2,550.00 EACH $ - $for additional depth over 4' $ 650.00 FT $ - $ - CB Type 11, 54" Dia $ 2,700.00 EACH $ - $for additional depth over 4' $ 600.00 FT $ - $ - CB Type 11, 60" Dia $ 2,900.00 EACH $ - $for additional depth over 4' $ 750.00 FT $ - $ - CB Type 11, 72" Dia $ 4,000.00 EACH $ - $for additional depth over 4' $ 900.00 FT $ - $ - Through-curb Inlet Framework(Add) $ 550.00 EACH $ - $ - Cleanout, PVC, 4" $ 200.00 EACH $ - $ - Cleanout, PVC, 6" $ 250.00 EACH $ - $ - Cleanout, PVC, 8" $ 300.00 EACH $ - $ - Culvert, Box ft x ft $ - LS $ - $ - Culvert, PVC, 4" $ 12.00 LF $ - $ - Culvert, PVC, 6" $ 17.00 LF $ - $ - Culvert, PVC, 8" $ 19.00 LF $ - 60 $ 1,140.00 Culvert, PVC, 12" $ 30.00 LF $ - $ - Culvert, CMP, 8" $ 23.00 LF $ - $ - Culvert, CMP, 12" $ 35.00 LF $ - $ - Culvert, CMP, 15" $ 42.00 LF $ - $ - Culvert, CMP, 18" $ 47.00 LF $ - $ - Culvert, CMP, 24" $ 69.00 LF $ - $ - Culvert, CMP, 30" $ 100.00 LF $ - $ - Culvert, CMP, 36" $ 150.00 LF $ - $ - Culvert, CMP,48" $ 194.00 LF $ - $ - Culvert, CMP, 60" $ 310.00 LF $ - $ - Culvert, CMP, 72" $ 400.00 LF $ - $ - Culvert, Concrete, 8" $ 36.00 LF $ - $ - Culvert, Concrete, 12" $ 43.00 LF $ - $ - Culvert, Concrete, 15" $ 52.00 LF $ - $ - Culvert, Concrete, 18" $ 55.00 LF $ - $ - Culvert, Concrete, 24" $ 85.00 LF $ - $ - Culvert, Concrete, 30" $ 136.00 LF $ - $ - Culvert, Concrete, 36" $ 165.00 LF $ - $ - Culvert, Concrete,42" $ 196.00 LF $ - $ - Culvert, Concrete,48" $ 210.00 LF $ - $ - Culvert, CPP, 6" $ 16.00 LF $ - $ - Culvert, CPP, 8" $ 22.00 LF $ - $ - Culvert, CPP, 12" $ 28.00 LF $ - $ - Culvert, CPP, 15" $ 34.00 LF $ - $ - Culvert, CPP, 18" $ 39.00 LF $ - $ - Rev 7/2017 CONSTRUCTION CALCULATION WORKSHEET Culvert, CPP, 24" $ 49.00 LF $ - $ - Culvert, CPP, 30" $ 62.00 LF $ - $ - Culvert, CPP, 36" $ 69.00 LF $ - $ - Ditching $ 12.00 CY $ - $ - Flow Dispersal Trench (1,436 base+) $ 40.00 LF $ - $ - French Drain (3'depth) $ 39.00 LF $ - $ - Geotextile, laid in trench, polypropylene $ 5.00 SY $ - $ - Infiltration pond testing $ 125.00 HR $ - $ - Mid-tank Access Riser,48"dia, 6'deep $ 2,025.00 EACH $ - $ - Pipe, High Density Water Pipe (HDWP) $ 160.00 LF $ - $ - Pipe, C900 $ 90.00 LF $ - $ - Pond Overflow Spillway $ 18.00 Sy $ $ Restrictor/Oil Separator, 12" $ 1,500.00 EACH $ $ Restrictor/Oil Separator, 15" $ 1,550.00 EACH $ $ Restrictor/Oil Separator, 18" $ 1,680.00 EACH $ $ Riprap, placed $ 52.00 CY $ $ Tank End Reducer(36" Dia) $ 1,280.00 EACH $ $ Thru-Inlet at CB $ 150.00 EACH $ $ Trash Rack, 12" $ 320.00 EACH $ $ Trash Rack, 15" $ 325.00 EACH $ - $ - Trash Rack, 18" $ 350.00 EACH $ - $ - Trash Rack, 21" $ 375.00 EACH $ - $ - WRITE-IN-ITEMS $ - $ - $ - SUBTOTAL: $ - $ 2,790.00 MOBILIZATION 10%: $ - CONTINGENCY 15%: $ - TOTAL: $ - $ 2,790.00 Rev 7/2017 CONSTRUCTION CALCULATION WORKSHEET GENERAL ITEMS Public Improvements Private Development Description Unit Price Unit Quantity Cost Quantity Cost Backfill &Compaction-embankment $ 8.00 CY $ - $ - Backfill &Compaction-trench $ 11.00 CY $ - $ - Clear/Remove Brush, by hand (acre) $ 2,363.00 ACRE $ - $ - Bollards-fixed $ 325.00 EACH $ - $ - Bollards-removable $ 600.00 EACH $ - $ - Clearing/Grubbing/Tree Removal $ 6,000.00 ACRE $ - $ - Excavation -bulk $ 2.50 CY $ - $ - Excavation -Trench $ 5.00 CY $ - $ - Fencing, cedar, 6'high $ 25.00 LF $ - $ - Fencing, chain link,4' $ 19.50 LF $ - $ - Fencing, chain link, vinyl coated, 6'hig $ 18.00 LF $ - $ - Fencing, chain link, gate,vinyl coated, $ 1,563.00 EACH $ - $ - Fencing, split rail, 3'high $ 14.00 LF $ - $ - Fill &compact-common barrow $ 27.00 CY $ - $ - Fill &compact-gravel base $ 30.00 CY $ - $ - Fill &compact-screened topsoil $ 45.00 CY $ - $ - Gabion, 12"deep, stone filled mesh $ 62.00 SY $ - $ - Gabion, 18"deep, stone filled mesh $ 86.00 SY $ - $ - Gabion, 36"deep, stone filled mesh $ 152.00 SY $ - $ - Grading,fine, by hand $ 2.00 SY $ - $ - Grading,fine,with grader $ 1.25 SY $ - 1011 $ 1,263.75 Guard Post $ 90.00 EACH $ - $ - Monuments $ 104.00 EACH $ - $ - Sensitive Areas Sign $ 20.00 EACH $ - $ - Sodding, 1"deep, sloped ground $ 10.00 SY $ - $ - Topsoil Type A(imported) $ 30.00 CY $ - $ - Traffic control crew(2 flaggers ) $ 98.00 HR $ - $ - Trail,4"chipped wood $ 9.00 SY $ - $ - Trail,4"crushed cinder $ 10.00 SY $ - $ - Trail,4"top course $ 9.50 SY $ - $ - Wall, retaining, concrete $ 66.00 SF $ - $ - Wall, rockery $ 13.00 SF $ - $ - WRITE-IN-ITEMS Subtotal $ - Subtotal $ 1,263.75 Rev 7/2017 CONSTRUCTION CALCULATION WORKSHEET STREET IMPROVEMENT Public Improvements Private Development Description Unit Price Unit Quantity Cost Quantity Cost AC Grinding,4'wide machine< 1000sy $ 35.00 SY $ - $ - AC Grinding,4'wide machine 1000-2001 $ 8.50 SY $ - 1011 $ 8,593.50 AC Grinding,4'wide machine>2000sy $ 2.50 SY $ - $ - AC Removal/Disposal/Repair $ 60.00 SY $ - $ - Barricade, Type 1 $ 36.00 LF $ - $ - Barricade Type II $ 25.00 LF $ - $ - Barricade, Type III ( Permanent) $ 55.00 LF $ - $ - Conduit, 2" $ 5.00 LF $ - $ - Curb&Gutter, rolled $ 20.00 LF $ - $ - Curb&Gutter,vertical $ 15.00 LF $ - $ - Curb and Gutter, demolition and disposE $ 20.00 LF $ - $ - Curb, extruded asphalt $ 5.00 LF $ - $ - Curb, extruded concrete $ 4.50 LF $ - $ - Guard Rail $ 30.00 LF $ - $ - Sawcut, asphalt, 3"depth $ 3.50 LF $ - $ - Sawcut, concrete, per 1"depth $ 3.00 LF $ - $ - Sealant, asphalt $ 2.00 LF $ - $ - Shoulder, gravel, 4"thick $ 11.00 SY $ - $ - Sidewalk, 4"thick $ 40.00 SY $ - $ - Sidewalk,4"thick, demolition and dispo $ 36.00 SY $ - $ - Sidewalk, 6"thick $ 45.00 SY $ - $ - Sidewalk, 6"thick, demolition and dispo $ 45.00 SY $ - $ - Signs $ - LS $ - $ - Sign, Handicap $ 100.00 EACH $ - $ - Striping, per stall $ 7.50 EACH $ - $ - Street Light System $ - LS $ - $ - Traffic Signal $ - LS $ - $ - Traffic Signal Modification $ - LS $ - $ - Striping,thermoplastic, (for crosswalk) $ 3.50 SF $ - $ - Striping,4" reflectorized line $ 0.40 LF $ - $ - AC Patching/Trenching Restoration $ 100.00 TON $ - $ - Controlled Density Fill (CDF) $ 90.00 CY $ - $ - WRITE-IN-ITEMS $ - $ - $ - $ - $ - $ - Subtotal $ - Subtotal $ 8,593.50 Rev 7/2017 CONSTRUCTION CALCULATION WORKSHEET TREET SURFACING/PAVEMENT Public Improvements Private Development Description Unit Price Unit Quantity F Cost Quantity Cost Asphalt Overlay, 1.5"AC $ 12.00 SY $ - $ - Asphalt Overlay, 2"AC $ 15.00 SY $ - 1011 $ 15,165.00 Asphalt Road 2", First 2500 SY $ 10.00 SY $ - $ - Asphalt Road 2", Qty. over 2500SY $ 9.00 SY $ - $ - Asphalt Road 3", First 2500 SY $ 15.00 SY $ - $ - Asphalt Road 3", Qty. over 2500 SY $ 13.00 SY $ - $ - Asphalt Road 5", First 2500 SY $ 22.00 SY $ - $ - Asphalt Road 5", Qty. Over 2500 SY $ 22.00 SY $ - $ - Asphalt Road 6", First 2500 SY $ 25.00 SY $ - $ - Asphalt Road 6", Qty. Over 2500 SY $ 24.00 SY $ - $ - Asphalt Treated Base,4"thick $ 14.00 SY $ - $ - Gravel Base Course 2" $ 7.50 SY $ - $ - Gravel Base Course 4" $ 15.00 SY $ - $ - Gravel Base Course 6" $ 22.50 SY $ - $ - Gravel Road,4" rock, First 2500 SY $ 15.00 SY $ - $ - Gravel Road,4" rock, Qty. over 2500 S $ 11.00 SY $ - $ - Concrete Road, 5", no base, over 2500 $ 22.00 SY $ - $ - Concrete Road, 6", no base, over 2500 $ 32.00 SY $ - $ - Thickened Edge $ 11.00 LF $ - $ - WRITE-IN-ITEMS $ - $ - $ - $ - $ - $ - Subtotal $ - Subtotal $ 15,165.00 Rev 7/2017 CONSTRUCTION CALCULATION WORKSHEET WATER SYSTEM Public Improvements Private Development Description Unit Price Unit Quantity F Cost Quantity Cost Blowoff $ 1,800.00 EACH $ - $ - Connection to Existing Water Main $ 2,000.00 EACH $ - $ - Ductile Iron Watermain,CL 52,6 Inch Dia $ 65.00 LF $ - $ - Ductile Iron Watermain,CL 52,8 Inch Dia $ 85.00 LF $ - $ - Ductile Iron Watermain,CL 52, 10 Inch Dia $ 103.00 LF $ - $ - Ductile Iron Watermain,CL 52, 12 Inch Dia. $ 125.00 LF $ - $ - Gate Valve,6 inch Dia $ 250.00 EACH $ - $ - Gate Valve,8 Inch Dia $ 380.00 EACH $ - $ - Gate Valve, 10 Inch Dia $ 425.00 EACH $ - $ - Gate Valve, 12 Inch Dia $ 500.00 EACH $ - $ - Fire Hydrant Assembly,with Guard Posts $ 3,000.00 EACH $ - $ - Fire Hydrant Assembly,without Guard Posts $ 2,500.00 EACH $ - $ - Air-Vac,8 Inch Dia $ 6,000.00 EACH $ - $ - Air-Vac,10 Inch Dia $ 7,500.00 EACH $ - $ - Air-Vac, 12 Inch Dia $ 12,000.00 EACH $ - $ - Pressure Reducing Valve Assembly,8 In. Di $ 3,800.00 EACH $ - $ - Pressure Reducing Valve Assembly, 10 In. D $ 4,200.00 EACH $ - $ - Pressure Reducing Valve Assembly, 12 In. D $ 5,000.00 EACH $ - $ - Valve Marker Post $ 350.00 EACH $ - $ - WRITE-IN-ITEMS $ - $ - $ - $ - $ - $ - Subtotal $ - Subtotal $ - Rev 7/2017 CONSTRUCTION CALCULATION WORKSHEET SANITARY SEWER Public Improvements Private Development Description Unit Price Unit —Q—u—a—ntit—yF Cost Quantity Cost Connection to Existing Sewer Main $ - EACH $ - $ - Clean Outs $ 500.00 EACH $ - $ - Grease Interceptor, 500 gallon $ 6,000.00 EACH $ - $ - Grease Interceptor, 1000 gallon $ 10,000.00 EACH $ - $ - Grease Interceptor, 1500 gallon $ 15,000.00 EACH $ - $ - Side Sewer Pipe, PVC.4 Inch Dia $ 8.00 LF $ - $ - Side Sewer Pipe, PVC. 6 Inch Dia $ 12.00 LF $ - $ - Sewer Pipe, PVC, 8 inch Dia $ 33.00 LF $ - $ - Sewer Pipe, PVC, 12 Inch Dia $ 41.00 LF $ - $ - Sewer Pipe, PVC, Inch Dia $ - LF $ - $ - Lift Station (Entire System) $ - LS $ - $ - Manhole,48 Inch Dia $ 3,000.00 EACH $ - $for additional depth over 4 feet/per fo $ 532.00 FEET $ - $ - Manhole, 54 Inch Dia $ 3,500.00 EACH $ - $for additional depth over 4 feet/per fo $ 532.00 FEET $ - $ - Manhole, 60 Inch Dia $ 3,700.00 EACH $ - $for additional depth over 4 feet/per fo $ 532.00 FEET $ - $ - Manhole, 72 Inch Dia $ 4,000.00 EACH $ - $for additional depth over 4 feet/per fo $ 625.00 FEET $ - $ - Manhole, 96 Inch Dia $ 5,000.00 EACH $ - $for additional depth over 4 feet/per fo $ 625.00 FEET $ - $ - Outside Drop $ - LS $ - $ - Inside Drop $ - LS $ - $ - Pipe, C-900 $ 90.00 LF $ - $ - Pipe, High Density Water Pipe(HDWP) $ 160.00 LF $ - $ - WRITE-IN-ITEMS $ - $ - $ - Subtotal $ - Subtotal $ - Rev 7/2017 CONSTRUCTION CALCULATION WORKSHEET LANDSCAPING &VEGETATION Include Public Improvements &Private Development Description Unit Price Unit Quantity Cost Street Trees $ 500.00 EACH $ - Root Barrier EACH $ - Median Landscaping $ - LS $ - Right-of-Way Landscaping $ - LS $ - Wetland Landscaping $ - LS $ - Private Landscaping $ - LS $ - WRITE-IN-ITEMS $ - $ - $ - $ - Subtotal $ - (INCLUDES GENERAL, STREET,SURFACING,WATER, PUBLIC PRIVATE SEWER, LANDSCAPING) SUBTOTAL $ - $ 25,022.25 MOBILIZATION 10%: $ - $ 2,502.23 CONTINGENCY 15%: $ - $ 3,753.34 GRANDTOTAL: $ - $ 31,277.81 Rev 7/2017 CITY OF ARLINGTON 18204 59th Avenue NE,Arlington,WA 98223 INSPECTIONS:360-403-3417-Permit Center:360-403-3551 CIVIL PERMIT 430 N WEST AVE Permit#:2673 Project Name:Autumnwood Properties Paving Parcel#:00618100500100 LOC/Project#: Expires: February 21, 2022 OWNER APPLICANT CONTRACTOR AUTUMNWOOD PROPERTIES LLC Bakhtiar Ardi Pribadi Fidalgo Paving&Construction 430 N WEST STE 1 430 N.West Ave Ste. 1 16825 45 Road ARLINGTON,WA 98223-6831 Arlington,WA 98223 Arlington,WA 98223 415-601-0095 360-652-2380 LIC#:FIDALPC946BK EXP:01/12/2022 JOB DESCRIPTION Grading/Paving CONDITIONS Install Oil water separators in both CB's per detail.It is the responsibility of the Owner,Developer and Contractor to adhere to the approved plans,verify compliance with the City of Arlington Municipal Code,Public Works Design and Construction Standards, International Code Council(ICC),applicable local,state and federal requirements or any order,proclamation,guidance or decision of the Governor. In addition,construction sites shall adhere to current COVID-19 Jobsite Safety Requirements as per local,state and federal regulations. INSPECTIONS • INSPECTIONS (360-403-3417) MUST BE CALLED IN BEFORE 3:30 PM TO BE ON THE NEXT BUSINESS DAY INSPECTION SCHEDULE • Inspections are Monday-Friday with exception of Local, State or Federal Holidays. Building, Storm and Civil Inspections - 8 am to 4:30 pm; Water or Sewer inspections - 8:00 am to 3:30 pm • To cancel or modify an inspection -Building, Storm or Civil call 360- 403-3433; Water or Sewer call 360-403-3526 • It is the responsibility of the Owner, Developer and Contractor to call and arrange for appropriate inspections. Onsite tailgate meetings are advised with each individual inspector prior to installation of their related facilities with those persons who are actually performing the work. • Failure to call for inspection may result in work being left exposed and/or removed and reconstructed • Re-inspections may be charged at $127.00 per hour, '/2 hour minimum for failure to call for inspection. PERMIT APPROVAL Work to be performed as described and/or shown in the approved plans and/or application for the above named project is approved for construction by the City of Arlington Public Works Department. All work is subject to field inspection. t--/ Nova Heaton 8/23/2021 Development Services Manager or Designee Print Name Date Signature The issuance or granting of this permit shall not be construed to be a permit for,or approval of,any violation of this Code or any other ordinance or order of the City,of any state or federal law,or of any order,proclamation,guidance advice or decision of the Governor of this State.To the extent the issuance or granting of this permit is interpreted to allow construction activity during any period of time when such construction is prohibited or restricted by any state or federal law,or order,proclamation,guidance advice or decision of the Governor of this State,this permit shall not authorize such work and shall not be valid.The building official is authorized to prevent occupancy or use of a structure where in violation of this Code,any other City ordinances of this jurisdiction or any other ordinance or executive order of the City,or of any state or federal law,or of any order,proclamation, guidance advice or decision of the Governor.The building official is authorized to suspend or revoke this permit if it is determined to be issued in error or on the basis of incorrect,inaccurate or incomplete information,or in violation of any City ordinance, regulation or order,state or federal law,or any order,proclamation,guidance or decision of the Governor. I hereby certify that I have read and examined this permit,the City of Arlington Land Use Code,the most current edition of the City of Arlington Standards and Specifications know the same to be true and correct all provision or laws and ordinances governing this type of work will be compiled with,which may include but are not limited to: Other City of Arlington development permits,WSDW Hydraulic Project Approval(HPA),WSDOE Notice of Intent(NO[),National Pollution Discharge Elimination Systems(NPDES),and Corp of Forest Practices Application(FPA).I also understande that all insurance,approved submittals for all materials and contractor's license. The contractor shall hold the City of Arlington harmless from any loss or damage to any person or property in the performance of said work. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of Arlington must be reported on your sales tax return form and coded City of Arlington#3101. Bakhtiar Pribadi 25AUG2021 Applicant Signature Print Name Date PERMIT FEES Date Name Description Fee Amount 08/23/2021 Processingrrechnology Fee $25.00 08/23/2021 Site Civil Review $2,044.07 Total Due: $2,069.07 Total Payment: $0.00 Balance Due: $2,069.07 CALL FOR INSPECTIONS Call by 3:30 pm for next day inspection,allow 48 hours for Fire Inspections When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon WIN City of Arlington Community & Economic Development I!D I November 2, 2021 Autumnwood Properties, LLC 430 N.West Ave.Ste. 1 Arlington,WA 98223 RE: Project Closeout Project Name: Autumnwood Properties Paving Project Address: 430 N.West Ave Project No.: PWD-2673 Dear Mr. Pribadi, The construction project for Autumnwood Properties Paving has been completed and submittal of all items related to the project closeout shall be required: 1. As-Built plans: a. Plans shall adhere to the Public Works Design and Construction Standard 1-11. b. Shall include all public and private infrastructure c. Submit one (1) full paper set along with the electronic format(PDF) d. AutoCAD files will be required with As-Built plan final approval Please feel free to reach out should you have any questions. 360-403-3551 Sincerely, ,/7 f f Raelynn Jones Permit Technician Community&Economic Development