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• • <br />PIJ�LIC WORKS PERIVIIT Date: 10/6/2016 <br />Public Works Permit #: PW1610-015 <br />City of Everett Public Works Department <br />3200 Cedar Street Parent Permit #: <br />L���'� Everett, WA 98201 Planning Reference #: <br />(425) 257-8810 <br />Public Works Fee $: $ 110.00 <br />Other $: <br />OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br />EVERETT CITY OF <br />3002 WETMORE AVE <br />EVERETT �/�/q 98201 <br />PHONE: 4252578956 <br />TAX PARCEL ID # 00451401200101 <br />INSTALL NEW OIL WATER SEPARATOR <br />BURTON CONSTRUCTION INC <br />1000 INDUSTRY DR <br />TUKWILA Wq 98188 <br />PHONE: 4252139889 <br />SITE ADDRESS: 3619 RUCKER AVE <br />FRIDAYS 1 ST ADD TO EVERETT BLK <br />�12 D-01 BLDG ONLY ON FDP LOTS 1 <br />THRU 11 REFER TO ACCT NO <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 />,::: , ..,_; <br />3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 �- ����' I:` <br />_. :_.., ; ., ,;_ ,. <br />,.: -,�, � , __ �r.,: .. <br />_ _ ,Ti�� <br />4. Site Civil Work to be done per plans approved by the City of Everett Public Works '-" <br />,� =; __.. _._. _ -,�, <br />_; „ <br />Department dated 10/19/2016. - � � w <br />5. Contact the City of Everett Public Works Inspector Randy Allen at 425-339-7403 prior ;� ": �"' <br />to starting construction and with other inspection requests. - [--I <br />6. Install erosion control measures per City of Everett Standards for small parcels and = �= �- � <br />�, �:::�.� `_� <br />remove upon completion of the project prior to final approval of the permit. `� :. <br />,.....� , ., <br />7. Keep City streets clean at all times. No dirt, mud, rocks, or debris to be tracked onto ,,;,a �, � <br />roadway. ;,:�„b �,, O <br />8. Protect all existing underground utilities during construction. ;_,� ,, � <br />9. Fire Department inspection is required for new Diesel Fuel Tank prior to Final ��_� `�� . <br />i..._- � +F.. ti=t #� �EtFt <br />A roval of ermit b Public Works Ins ector. ��=� �� '-'=� "=� �: ��` � ,'Z <br />pP p Y P �, a � <br />Public Works Permit Fee Breakdown: <br />Paving....................................................... $45.00 <br />Misc. Minor Permits (Drainage Work).......$25.00 <br />PW Plan Review .......................................$20.00 <br />PW Site Inspection ....................................$20.00 <br />for Construction <br />FINAL INSPECTION <br />Approved as Constructed <br />���jii� <br />� <br />Date <br />-.". �"' ..-. --. ..--. _.. -, `°� =f ' O <br />�_`., � <br />� <br />0 <br />� <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harmless the <br />City of Everett from any and all claims for damages, costs, expenses, or <br />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 />remove same upon notice from the City and to replace public property <br />damaged the by. <br />��� ) <br />�� � � <br />� <br />Signature of pplicant D te <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 />�/ � <br />