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'UBLIGAVORKS PERMIT 0 Date Applied: 6/4/2018 <br />City of Everett Permit Services Public Works Permit #: PW1806-004 <br />3200 Cedar Street, 2"d Floor Associated Bldg Permit #: <br />Everett, WA 98201 Planning Reference #: <br />(425) 267-8810 Public Works Fee: $85 <br />2 9 JAN 219 <br />OWNER NAME AND ADDRESS: <br />APPLICANT NAME AND ADDRESS: <br />WAL-MART REAL ESTATE BUSINESS TRUST <br />ELECTRIFY AMERICA <br />2001 SE 10TH ST <br />5885 Meadows Road Suite 700 <br />BENTONVILLE, AR, 72716 <br />LK OSWEGO, OR, 97035 <br />PHONE: <br />PHONE': 5414903080 <br />TAX PARCEL ID #: 28051800405600 <br />SITE ADDRESS: 1605 SE EVERETT MALL WAY <br />DESCRIPTION: INSTALL 10 BAY ELECTRIC CAR CHARGING STATION <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 <br />and Specifications 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 dated 06/04/2018. <br />Approved plans must remain on job -site during work hours. <br />5. Contact the City of Everett Public Works Inspector Jim Knappert at 425-339-7404 prior to starting construction for a <br />consultation, to evaluate Erosion/Sedimentation control set-up, and with all other inspection requests. <br />6. Install and maintain erosion control measures per City of Everett Standards and the Public Works Inspector's direction in <br />the field. Remove upon completion of the project prior to final approval of the permit. <br />7. Keep the work site and 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 />10. This permit must be finaled in order to close out this permit. Call the inspection line to request a Final for this permit <br />when all work has been completed. <br />Public Works Permit Fee Breakdown: <br />Misc. Minor Paving.....................................$45.00 <br />PW Plan Review..........................................$20.00 <br />PW Site Inspection.....................................$20.00 <br />JAN 2 9 2019 <br />CITY OF EVERETT <br />Permit Services <br />Oty of Everett Official Use Only ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save <br />6/04/201 8 harmless the City of Everett from any and all claims for damages, costs, <br />expenses, or causes of action that may arise because of installation and <br />maintenance of the improvement or other right-of-way use here to applied <br />Approved for Construction (Public Works) Date for and further agrees to remove same upon notice from the City and to <br />replace public property damaged thereby. <br />FINAL INSPECTION Date t 1 <br />Approved as Constructed (PW Inspector) Signature plicant Date <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 <br />COMPLETEION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90-DAY DURATION. <br />