2521 LOMBARD AVE 2017-06-13 - Laserfiche WebLink

I PUBLIC vrORKS PERMIT Date: 6/10/2016 Public Works Permit#: PW1606-016 City of Everett Public Works Department 3200 Cedar Street Parent Permit#: �s Everett, WA 98201 (425) 257-8810 Planning Reference#: Public Works Fee $: $ 90.00 Other $: OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: IMMANUEL LUTHERAN CHURCH HOYT DONALD/DBA SEAL COAT 2512 LOMBARD AVE 8415 200TH ST SE EVERETT WA 98201 SNOHOMISH WA 98296 PHONE: 4252527038 PHONE: 3606686122 TAX PARCEL ID# SITE ADDRESS: 2521 LOMBARD AVE REPLACE EXISTING ASPHALT IN PORTION OF PARKING LOT NO CHANGE IN THE NUMBER OF PARKING SPACES NO CHANGE IN LANDSCAPING NO CHANGE TO ACCESSIBLE SPACES NO WORK ON SUBGRADE 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 hrs before you dig. TOLL FREE NUMBER 811 _Q 4. Contact the City of Everett Public Works Inspector Randy Allen at 425-339-7403 prior '— C' .. to starting construction and with other inspection requests. See attached to request an Z�ty inspection. 5. Any damage to the City Sidewalk or other improvements shall be replaced at the direction of the City Public Works Inspector. - = 6. Keep City streets clean at all times. 7. Provide any erosion control as directed by the Public Works Inspector. Public Works Permit Fee Breakdown: o MISC MINOR PERMIT$25.00 PARKING LOT PAVING$45.00 PW SITE INSPECTION$20.00 0 ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant 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 or other right-of-way use hereto applied for and further agrees to Apprdved for Construction Date remove same upon notice from the City and to replace public property dam gr d thereby. FINAL INSPECTION Date Approved as Constructed 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 CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.