1020 N BROADWAY BASE FILE 2023-11-28

PUBLIC WORKS PERMIT Date Applied: 12/17/2021 City of Everett Permit Services Public Works Permit#: PW2112-039 3200 Cedar Street, 2"d Floor Associated Bldg Permit#: E V E R E T T Everett, WA 98201 Planning Reference#: WASHINGTON 425-257-8810 Public Works Fee: $65.00 OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: KOZ ON N BROADWAY LLC DAN REYNOLDS 1830 BICKFORD AVE UNIT 201 SNOHOMISH,WA,98290 PHONE:2067551290 PHONE:2066785122 TAX PARCEL ID#:29051700203200 SITE ADDRESS: 1020 N BROADWAY DESCRIPTION: REMOVE&REPLACE POTENTIAL CONTAMINATED SOIL THIS PERMIT TO BE POSTED ON JOB SITE AT ALL TIMES PERMIT CONDITIONS: 1. All calls for inspection shall be made 24 hours in advance. 2. All work shall be performed in accordance with the permit and current City of Everett`Design and Construction Standards and Specifications for Development. 3. Call Location Underground Service 48 hours before you dig.The day you call does not count.TOLL FREE NUMBER 811. 4. Site Civil Work to be done per plans approved by the City of Everett Public Works Department.Approved plans must remain on job-site at all times. 5. It is the applicant/contractor's responsibility to ensure coverage under Ecology's Construction Stormwater General Permit is obtained and maintained throughout the entire construction duration. 6. Inspections are required for all stages of construction.Visit the City's Online Permitting Portal at pw.everettwa.gov to formally request all required inspections. 7. Install and maintain erosion control measures per City of Everett Standards and per the direction of the PW Inspector or the approved SWPPP/TESC Plan. Remove upon completion of the project prior to final approval of the permit. 8. Keep City streets clean at all times. No dirt,mud,rocks,or debris to be tracked onto roadway. 9. Protect all existing underground utilities(to remain)during construction. 10.All excavated material shall be hauled to an approved,permitted site. 11. Prior to any interruption to the public right-of-way(roadways,parking lanes,or sidewalks)a haul route will be required to be submitted to the City of Everett prior to permit issuance.Contact the Traffic Engineering Department for Street Use Permits and any required Oversize Load Permits at 425-257-8810(press Option 7 for Traffic). 12.This permit must be finaled in order to close out this permit/grant a Certificate of Occupancy. Request a final inspection online by selecting PW 25-Site Final/Permit Close Out within the Online Permitting Portal Inspection Requests when all items have been completed for this permit. Public Works Permit Fee Breakdown: Grade/Fill/Excavate(30CY)........................$25.00 PW Plan Review........................................$20.00 PW Site Inspection....................................$20.00 City of Everett Official Use Only ACKNOWLEDGEMENT OF CONDITIONS By purchasing this permit and commencing work,the owner/applicant hereby agrees to hold and save harmless the City of Everett from any and all claims for damages,costs,expenses,or causes of action that may arise because of installation and maintenance of the 7Qtl1LG 176� 12/20/2021 improvement or other right-of-way use here to applied for and further agrees to remove same upon notice from the City and to replace Approved for Construction, Public Works Dept. Date public property damaged thereby. 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 MAY BE CANCELLED BY THE 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. _APPLICANT/JOB SITE COPY _TREASURER _ADDRESS FILE