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PUBLIC WORKS PERMIT <br />City of Everett Public Works Department <br />3200 Cedar Street <br />Everett, WA 98201 <br />(425)257-8810 <br />Date. <br />12/18/2009 <br />Public Works Permit # <br />PWO912-022 <br />Buildinq Permit #, <br />C0912-013 <br />Planning Reference # <br />Y, <br />Public Works Fee S: <br />S 25.00 <br />Other $ <br />OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br />BRAINARD JASON A <br />10603 13TH AVE W <br />EVERETT WA 96204 <br />PHONE: 4252318674 PHONE: <br />TAX PARCEL ID # 00552500000701 SITE ADDRESS: 10603 13TH AVE W <br />DESCRIPTION OF PROPOSED WORK <br />NEW ADDITION <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 r — <br />4. Connect rooftop downspouts to the drainage system provided for this lot <br />5 No dirt, mud, rocks or debris to be tracked onto roadway <br />Approved1for Construction Date <br />INSPECTION Date <br />Approved as Constructed 8— 7J �� <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF <br />PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UP <br />LTJ <br />,1 <br />oil <br />G <br />Lil <br />"r_, <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and <br />save harmless the City of Everett from any and all claims for <br />damages, costs, expenses• or causes of action that may arise <br />because of installation and maintenance of the improvement <br />or other right-of-way use hereto applied for and further agrees <br />to remove same upon notice from the City and to replace <br />public proper y damaged thereby. r <br />-�C <br />RMFT 15 ISSUED AND THEREAFTER IS TO BE DILIGENTLY <br />STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />