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PUBLIC ARKS PERMIT Date: 3/1/2016 <br /> City of Everett Public Works Department <br /> Public Works Permit#: PW1603-003 <br /> 3200 Cedar Street Parent Permit#: C1602-001 <br /> Everett, WA 98201 Planning Reference#: <br /> (425)257-8810 <br /> Public Works Fee$: $ 65.00 <br /> Other$: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> GERAY CHRISTOPHER S <br /> 1726 SILVER LAKE RD <br /> EVERETT WA 98208 <br /> PHONE: 2064191688 PHONE: <br /> TAX PARCEL ID# 00494300500500 SITE ADDRESS: 1726 SILVER LAKE DR <br /> CHANGE EXTG GABLE ROOF AT HOUSE, REPL GARAGE ROOF, ETC. <br /> Public Works associated with New Roof-Downspout Managment. <br /> LAKEVIEW SUBDIV 2 BLK 005 D-00- <br /> LOT 5 INC ADJ SHORELANDS BLK 5 <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 <br /> and Specifications. <br /> 3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 PR <br /> 4. Site Civil Work to be done per plans approved by the City of Everett Public Wj J}s.,..... <br /> Department dated 3/1/2016. co-2 -,, --' <br /> 5. Contact the City of Everett Public Works Inspector Jim Knappert at 425-12F-MWE c _'. c--3 3� w <br /> prior to starting construction and with other inspection requests. <br /> 6. Install erosion control measures per City of Everett Standards for small parcels (or as c <br /> directed by the Public Works Inspector) and remove upon completion of the progect prior <br /> to final approval of the permit. -= � <br /> 7. Keep City streets clean at all times. No dirt, mud, rocks, or debris to be traced onto c <br /> roadway. q, � <br /> 8. It is the applicant/owner's responsibility to ensure that stormwater runoff a. a new <br /> impervious surfaces will be managed on-site in a manner that does not adv*--..,-y f o ;?;gosi, <br /> neighboring properties, including the City's right-of-way and/or easements artd�lthE-'P L ; 'C..r,:="• -a ryist <br /> improvements located therein. <br /> c-7 a c•a <br /> Public Works Permit Fee Breakdown: <br /> Misc. Minor Permits(Drainage Work) $25.00 <br /> PW Plan Review $20.00 <br /> PW Site Inspection $20.00 �I <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harmless the <br /> JCity of Everett from any and all claims for damages,costs,expenses,or <br /> j— ®�� causes of action that may arise because of installation and maintenance of the <br /> improvement or other right-of-way use hereto applied for and further agrees to <br /> Approved for Construction Date <br /> remove same upon notice from the City and to replace public property <br /> damaged thereby. <br /> l <br /> FINAL INSPECTION Date M <br /> Approved as Constructed Signature of Applicant at <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY <br /> PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br /> Fd <br />