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4. PUBLIC WORKS PERMIT Date: 3/31/2016 <br /> Public Works Permit#: PW1603-080 <br /> Err City of Everett Public Works Department <br /> 3200 Cedar Street Parent Permit#: C1603-069 <br /> Everett, WA 98201 Planning Reference#: <br /> (425) 257-8810 <br /> Public Works Fee $: $ 40.00 <br /> Other $: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> BRUCE JASON R AND HOLLIANN <br /> 5510 OCEAN AVENUE <br /> EVERETT WA 98203 <br /> PHONE: PHONE: <br /> TAX PARCEL ID# 00396700400300 SITE ADDRESS: 5510 OCEAN AVE <br /> SFR ADDITION &ATTACHED GARAGE <br /> ADDING MASTER SUITE <br /> BRIDLE PARK BLK 004 D-00 - LOT 3 <br /> BLK 4 <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 NUMBEF _$11 ° <br /> 4. The contractor must contact the Public Works Inspector to discuss potential �Jin <br /> routing prior to beginning the project. Call Randy Allen at 425-339-7403. <br /> 5. No dirt, mud, rocks, or debris to be tracked onto roadway. <br /> 6. It is the applicant/owner's responsibility to ensure that stormwater runoff from nkw <br /> impervious surfaces will be managed on-site in a manner that does not adversely 4fect _r.. <br /> neighboring properties, including the City's right-of-way and/or easements and t"­0 0 <br /> improvements located therein. t <br /> p o� r.�r•a c� �n r.� c� <br /> Public Works Permit Fee Breakdown: Cj <br /> -a0 <br /> PW Plan Review$20.00 _,x' <br /> PW Site Inspection $20.00 , <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harmless the <br /> City of Everett from any and all claims for damages,costs,expenses,or <br /> - �j causes of action that may arise because of installation and maintenance of the <br /> A r ed for Construction Date improvement or other right-of-way use hereto applied for and further agrees to <br /> pp remove same upon notice from the City and to replace public property <br /> damaged thereby. <br /> FINAL INSPECTION Date "m4=a kt Vim., 13yu u_ <br /> Approved as Constructed Signature of Applicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY <br /> PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />