1415 ROCKEFELLER AVE 2016-01-01 MF Import

�" PUBLIC WORKS PERMIT Date: 4/29/201A ''Q ' Public Works Permrt N, PW1404-039 � '� City of Everelt Public Works Department ,e�, , �� 3200 Cedar Street Buildin� Permit#; 61404-03 .,.� Everett, WA 98201 Planning Reference#: (425) 257-8810 Public Works Fee$: $ F� Other$: OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: JORGENSEN ROBIN JORGENSEN ROBIN 1415 ROCKEFELLER 1415 ROCKEFELLER EVERETT WA 9820� EVERETf WA 98201 PHONE: 4252593423 PHONE: 4252593423 TAX PARCEL ID# 00475429000700 SI7E ADDRESS: 1415 ROCKEFELLER AVE DESCRIPTION OF PROPOSED WORK: PUBLIC WORKS PERMIT CONCITIONS 1. All calls For inspection shall be made 24 hours in advance. 2. All work siiall be periormed in accordance with the permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 4. The contractor must meel with the Public Works Inspector to discuss a storm water system prior to beginnin�he Gj project Ca9 Randy Allen at425•339-7403. .-�-.-- .-.- � � W i��ac�c�-. o • �~ � �tzn� � r (� r o M � r��5 F�q c-i i O �-- '.�'y � �z � 0 . c:° r�r�wc w� LT.��I^Cp'1G�GpC FL�1t. i��/� CnV10GGS JjOL~�1 C�••VJ -�-�.�i�t�l� �--� a ACKNOWLEDGEMENT OF CONDITIONS The undersigned ownerlapplicant hereby agrees lo hold and save harmless the City of Everett from any and all claims(or damages,cosls, expenses, or causes of action that may arise because of inslall � nd maintenance of Ihe improvemen� � � or other right-o ay u e hereto applied for and further agrees to remove sa upo notice from tne City and to replace Appr r nstruc Date public pro dam ged thereby. , / NAL INS TION Dat� 26� ¢ � _ /f /� 7 Approved as Constructed Signature o pplic t Date �VORK AUTHORIZED BY THIS PERMR MUST BE S7ARTED WRHIN 180 DAYS OF DATE PERM ISSU AND TNEREAFfER IS TO BE DIUGENTLY PURSUED TO COMPLETION. THIS PERMR MAY BE CANCELLED BY TNE CffV UPON ANY STOPPAGE 0 WORK ON THIS PRO)ECi OVER 90 DAYS DURATION. pv� . .