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i <br /> PUBLIC WORKS PERMIT Date: 9/6/2011 <br /> Public Works Permit#: F'W1109-013 <br /> City of Everett Public Works Departme�it Building Permit#; C1108-022 <br /> 3200 Cedar Street <br /> Everett, wA 98205 Planning Reference#: <br /> (a25)257-8870 pubiic Works Fee$: S 25.00 <br /> Other$: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND AODRESS: <br /> CORNERSTONE HOMES NW LLC <br /> PO BOX 14424 <br /> MILL CREEK WA 9808z <br /> PHONE: <br /> PHONE: <br /> TAX PARCEL i0 M 0053i900001302 SITE ADDRESS: 11040 PAINE FIELD WY#10 <br /> DESCRIPTION OF PROPOSED WORK: <br /> NEW HOUSE -BASIC412A <br /> COBBL.ESTONE COTTAGE; <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 Sta�dards <br /> and Specifications. <br /> 3. Call Location Underground Service 4d hrs before you dig. TOLL FREE NUMBER 811 <br /> �, � _� <br /> 4. Connect side sewer per City Standard iF's 601, 602, 604. _ ���� � � <br /> 5. Connect rooftop downspouts to the drainage system provided � ��T,�:r, � ' <br /> 6. No dirt, mud, rocks or debris to be tracked onto roadway. r r� ����d o ►•y <br /> c �uS� r� � <br /> CONTACT INSPECTOR CLIFF LINDMAN AT 425339-7404 WITH QUESTIONS AND�OR�JSPECTIOa m <br /> F� ' � <br /> � ^ ���� <br /> 1 > <br /> H � � <br /> � <br /> ' _.� <br /> �� �.t,Mv:� .A, <br /> �W�G Y.J�.G�n(.�.�1 y� <br /> �OLtI'.�OOF•W <br /> �.;�ng�Bvv�A �- `.;:, <br /> -�ro 0 <br /> _� ^ , <br /> r-. ^ <br /> �-.-� <br /> TO P35TING °"��= <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and <br /> save hartnless the City of Everett from any and ail claims for <br /> damages,costs,expenses,or causea of action that may arise <br /> because of installation and maintenance o(the improvement <br /> ��;���c�� (:'� _// or other right-of-way use hereto applied for and fuAher agrees <br /> � to remove same upon notice irom the City and to replace <br /> Approved fo�Construction Date public property damaged thereby. <br /> �-� /� —� 1/�l„� .Qivs�,e� 91� I I� <br /> INSPECTION Date <br /> Approved as Constructed �—Z3-1� Signature oi Applicent Date <br /> WORK AUTHORIZED BY TH[5 PERMR MUST BE STARiED WffHIN t80 DAYS OF DATE PERMIT IS ISSUED AND iHEREAFfER 15 TO NE DILIGENTLY <br /> PURSUED TO COMPLEfION. THIS PERMIT MAY BE CANCELLED BY THE CiTY UPON ANY STOPPAGE OF WORK ON iHiS PRO]ECT CYER 90 DAYS DURA� <br /> / <br />