4327 RUCKER AVE PAC NW DENTURE AND DENTIST 2018-01-02 MF Import

PUBLIC WORKS PERMIT City of Everett Public Works Department 3200 Cedar Street Everett, WA 98201 (425) 257 8810 Date: 4/22/2014 Public Works Permit #. PW 1404-032 Buildinq Permit #, Planninq Reference #: Public Works Fee $: $653.00 Other $: OWNER NAIVE AND ADDRESS: APPLICANT NAME AND ADDRESS: PSE CARA CROW 13330 STONE AVE N SAME SEATTLE WA 98133 PHONE: 2069495846 PHONE: TAX PARCEL ID # SITE ADDRESS: 4327 RUCKER AVE DESCRIPTION OF PROPOSED WORK: REPLACE GAS MAIN (4/2212014 4.21 PM BES) REPLACE 4" GAS MAIN WITH 653 FEET 2" MAIN 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. 3. Call Location Underground Service 48 firs before you dig. TOLL FREE NUMBER 811 4. Replace any damaged City utilities. 5 Pavenment patching shall per City of Everett Standards(#316) 6 Traffic control shall be per approved plan 4/18/2014. 7 Contact City of Everett Inspector Randy Allen 425-339-7403 prior to starting construction. C Ct. ,%Swot 5-13-14 G O G ACKNOWLEDGEMENT OF CONDITIONS The undersigned ownerlapplicanl 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 improvement LS blr / or other right-of-way use hereto applied for and further agrees e or Con rue i n Dal r to remove same upon notice from the City and to replace f public pro erty damaged thereby. INSPECTION Date ved as Constructed I Signature of Applicant Date 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 CI1Y UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. t� k