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Date 5/12I2011 <br /> � PUBLIC WORKS PERMIT public Works Permit#: PW1105-007 <br /> Ciry of[veretl Public Works Deparlment guildinq Permil#; C1104-011 <br /> r��..� y,,, , , 3200 Cedar Street <br /> ��+� ' [vereU, WA 98201 Plan�inq Reference#: <br /> (425) 257-8810 public Works Fee 3: $ 25 00 <br /> Other 5' <br /> APPLICANT NAME AND ADDRESS: <br /> OWNER NAME AND ADDRESS: <br /> SGRIGNOL KEVIN J & JANELLE K <br /> 906 110TH PL SE <br /> EVGRETT WA �8z�8 <br /> PhIONE: <br /> PHONE: <br /> TAX PARCEL ID# OOi'fi2600000700 SITE ADDRESS: 90G 110TH PL SE <br /> DESCRIPTION OF PROPOSED WORK: <br /> ADDITION/REMODEL <br /> PERMIT CONDITIONS <br /> 1 All calls for inspection shall be made 24 hours in advance <br /> 2 All work shall be periormed in accordance wilh the permi!and currerd City of Fverett Des�qn am.l CensVud�on Standards <br /> and Specifications- -- <br /> 3 Call Location Undergro�md Service 48 hrs before you dig TOLL FREE NUMBER 811 <br /> 4 Connect rooftop downspouts to the drainage system provided for lhis bt w <br /> , The contractor must meet with the Public V1'orks Inspector to discuss potenlial drainage routieg prior to begmning � <br /> the project CALL CI IFF I IN�MAN AT 425-339•7404 � <br /> 6 No dirt, mud, rocks or debris lo be tracked onto roadway. � <br /> 7 No building materials to be stacked on sidewalk/roadway and side�.valklroadway lo be kepl clean and open for � <br /> pedeshian travel Q <br /> ^7 <br /> 'T_.. <br /> O <br /> F� <br /> ✓� <br /> O <br /> a <br /> TO POSTING 1\"1�1�i3 ,,�������,���-������_�.,� N, o� ��,�����,���NS <br /> l lie undersigned oemeilapplicanl hereby agrees lo hold and <br /> save harmless�he Cily ol Everelt from arry and all claims lor <br /> - � ----- ----- damages,costs, e�penses, or causes of aclion Ihat may arise <br /> because ol installation and mainlenance ol the improvemenl <br /> or o�her nghl-of-way use hereb�pplied for and luriher ayrees <br /> �i' ' � � 5���-��� � lo remo same upon nolice from the Cily end to repiace <br /> i��.npr ed for Construclion Ddte public pr perty d ma9ed ther by <br /> i <br /> �-�' , ����.-.� �_ �� %", � �� C�t� � 7� �� <br /> II SPECTION Date , <br /> l�pproved as Constructed � "/�'�—� Slgnolure ol Applican Date <br /> ;.i a;K AUTHORIZFD OY THIS PfRPiR h1U5T BE START[D WITHIN 180 DAYS OF MTE P[RP11T IS ISSU AND THEREAFTFR IS TO BE DILIGENTLY <br /> I���:����I p 1 n r01�11��I I IO�J 1�i15 PI RI�11T F+�1'f3f CM1CfI.LLD BV TN[CI1V UPON ANY STOPPAGE OF Vr'ORK ON THIS PROIECT OVER 90 DAVS DURATION. <br />