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t7 <br />EVERETT <br />WASHINGTON <br />PUBLI�ORKS PERMIT <br />City o Jerett Permit Services <br />3200 Cedar Street, 2"d Floor <br />Everett, WA 98201 <br />425-257-8810 <br />Date Applied: 12/19/2019 <br />Publi�rks Permit #: PW1912-040 <br />Associated Bldg Permit #: <br />Planning Reference #: <br />Public Works Fee: $65 <br />OWNER NAME AND ADDRESS: <br />APPLICANT NAME AND ADDRESS: <br />HNM LLC <br />ANDYYIM <br />719 GRAND AVE <br />EVERETT, WA, <br />�J <br />�� <br />, , <br />PHONE: 4254187912 <br />PHONE: 4253220253 <br />TAX PARCEL ID #: 00439149401700 <br />SITE ADDRESS: 2332 BROADWAY <br />DESCRIPTION: SOIL SAMPLING/TESING BORE HOLES (3) <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. Traffic Control must be done in accordance with MUTCD Standards and the Traffic Control Plan approved by City of <br />Everett dated 01/13/2020. <br />5. Any damage to City improvements (sidewalk, curb, roadway, etc.) shall be replaced per City Standards and/or as <br />directed by the City PW Inspector. i <br />6. Street restoration and trench restoration must be done per COE Standard , or as directed by the-C-4y--PW I ped�tQ :' <br />Permanent restoration must be completed within 2 weeks of completion of utility work. Ia=i F5 �- <br />7. A minimum of 5ft separation between City of Everett utilities and directional boring/paved enttxt stall f <br />maintained. `�'' ``'''; 1.2 <br />3 •.,;i <br />8. Inspections are required for all stages of construction. Visit the City's Online Permitting Portal at pw.evere,wa.V:to <br />formally request all required inspections. Inspections are required for job start notification, potholing all City utilita� I <br />evaluation of traffic control set-up, to view the work prior to backfill, and after final restoration to final the permit. <br />9. Potholing required for all crossings over/under City of Everett water mains. , <br />—i <br />10. Coordinate with adjoining businesses/homeowners to minimize obstruction of commerce Adcess. I <br />.. C j t~ .. <br />o T7 0 Y , <br />Public Works Permit Fee Breakdown: <br />F"D <br />Misc Minor Permits And/Or Plan Reviews................$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 />The undersigned owner/applicant hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damages, costs, expenses, or <br />Cocauses of action that may arise because of installation and maintenance of <br />A roved for Constructio bliC Works) ate the 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 public <br />property damaged thereby. <br />FINAL INSPECTION Date <br />Approved as Constructed (PW Inspector) Signature of Applicant 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 COMPLETION. THIS PERMIT MAYBE 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 />