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UBLICWORKS PERMIT <br />City of Everett Public Works Department <br />3200 Cedar Street <br />Everett, WA 98201 <br />(425) 257-8810 <br />Date Applied: 10/19/2017 <br />Public Works Permit #: PW1710-027 <br />Parent Permit #: <br />Planning Reference #: <br />Public Works Fee: $65 <br />14 DEC 2017 <br />OWNER NAME AND ADDRESS: <br />APPLICANT NAME AND ADDRESS: <br />GARZA RUDOLFO R <br />GARZA RUDOLFO R <br />1909 MONROE AVE <br />1909 MONROE AVE <br />EVERETT, WA, 98203-5326 <br />EVERETT, WA, 98203-5326 <br />PHONE: <br />PHONE: <br />TAX PARCEL ID #: 00545002702200 <br />SITE ADDRESS: 1909 MONROE AVE <br />DESCRIPTION: SITE WORK FOR ADU <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 11/13/2017. (copy <br />attached) <br />5. Any damage to the City Sidewalk or other improvements shall be replaced at the direction of the City Public Works <br />Inspector. <br />6. It is the applicant/owner's responsibility to ensure that stormwater runoff from new impervious surfaces will be managed <br />on -site in a manner that does not adversely affect neighboring properties, including the City's right-of-way and/or easements <br />and the improvements located therein. <br />7_ Contact the City of Everett Public Works Inspector Randy Allen at 425-339-7403 prior to starting construction and with all <br />other inspection requests. See attached to request an inspection. <br />8. Applicant is required to sign a hold -harmless agreement with regards to the use of the 4" side -sewer. <br />Public Works Permit Fee Breakdown: <br />Misc Minor Permits And/Or Plan Reviews .....................$25.00 n n <br />PW Plan Review........................................................... $20.00 �rz� <br />PW Site Inspection.......................................................$20.00 <br />DEC 14 20V <br />TT <br />CITYOF <br />Pe Services <br />City of Everett Official Use Only ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/a0plicant hereby agrees to hold and save <br />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 />ApVtovdd for Constructio blic Works) 6ate for and further agrees to remove same upon notice from the City and to <br />replace public property dama ereby. <br />FINAL INSPECTION Date <br />Approved as Constructed (PW Inspector) Signature o lican 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 />M <br />