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PUBLIC SORKS PERMIT <br />City of Everett Public Works Department <br />3200 Cedar Street <br />Everett, WA 98201 <br />(425) 257-8810 <br />OWNER NAME AND ADDRESS: <br />COUNTRY CLUB PRESERVATION LP <br />21515 HAWTHORNE BLVD STE 125 <br />1 4-1-116 <br />Date: 912V2016 <br />Public Works Permit #: PW1609-095 <br />Parent Permit #: <br />Planning Reference #: <br />Public Works Fee $: $ 85.00 <br />Other $: <br />APPLICANT NAME AND ADDRESS: <br />TORRANCE CA 90503 <br />PHONE: PHONE: <br />TAX PARCEL ID # 28051900101700 SITE ADDRESS: 1306 100TH.ST I?L, <br />SITE MODIFICATIONS <br />(11/15/2016 9:09 AM BES) <br />REPLACE SOME CEMENT CONCRETE SIDEWALK, REPAVE AND STRIPE PARKING <br />N68*17 10W 97.1 OFT TO TPB <br />(EXEMPT PER ST OF WA REG <br />#10140-003) <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 />3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 <br />'; <br />. <br />-1. <br />4. Site Civil Work to be done per plans approved by the City of Everett Public Works 1-- r �- F <br />w,' <br />' <br />Department dated 11/15/2016. _ <br />-` � <br />5. Contact the City of Everett Public Works Inspector Jim Knappert at 425-339-740 �� ` <br />prior to starting construction and with other inspection requests: <br />6. Remove and replace curb, gutter, and sidewalk as per City of Everett Standard Plan <br />#'s 305A & 306. Install ramps per ADA standards. <br />C-1, <br />M <br />7. Keep City streets clean at all times. No dirt, mud, rocks, or debris to be tracked onto <br />roadway. <br />8. Protect all existing underground utilities during construction. <br />•ELF �-• <br />;may <br />'tM"', <br />M <br />�^. •YF •YF •EPEE ,::!^. (',:) •--:7 <br />..:i� <br />" Public Works Permit Fee Breakdown: �'X =^' a ' n'"} n"' ' u ' <br />c' 1' ==P (I b 9- S'd Ik R t fI$45 00 ' .r:' <br />-C <br />aving ( uewa es ora on)..... <br />PW Plan Review.......................................$20.00 <br />PW Site Inspection....................................$20.00 <br />4 CCa <br />co <br />K., <br />C) <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harmless the <br />F _ City of Everett from any and all claims for damages, costs, expenses, or <br />4J I causes of action that may arise because of installation and maintenance of the <br />istruct Da improvement or other right-of-way use hereto applied for and further agrees to <br />remove same upon not�fro9:0!i�ty�andplace public property <br />d thereby. 1-1 <br />FINAL INSPECTION Date <br />Approved as Constructed <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN386bAYS 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 />r-1 L(s <br />