900 PACIFIC AVE WOMEN AND CHILDREN PAVILLION 2018-12-07

ji 154(1° PUBLIC WORKS PERMIT Date: 11/ 6 City of Everett Public Works Department Public Works Permit#: PW1611-017 3200 Cedar Street Parent Permit#: B1610-013 Everett, WA 98201 Planning Reference#: (425)257-8810 Public Works Fee$: $ 65.00 Other$: OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: PROVIDENCE HEALTH &SERVICES- 1801 LIND AVE SW#9016 RENTON WA 98057 PHONE: PHONE: TAX PARCEL ID# 29053000200300 SITE ADDRESS: 900 PACIFIC AVE SITE WORK FOR 2600SF OUTDOOR PLAY AREA CANOPY-PRMC Drainage work associated with installing new play area canopies. 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 —4R1 4. Site Civil Work to be done per plans approved by the City of Everett Public Works : � '"' Department dated 11/8/2016. , 5. Contact the City of Everett Public Works Inspector Randy Allen at 425-339-7403 prior = = w �,_,1-7.1m to starting construction and with other inspection requests. ?- ru [moi 6. Install erosion control measures per City of Everett Standards for small parcels and PI* remove upon completion of the project prior to final approval of the permit. rri w) I 7. Keep City streets clean at all times. No dirt, mud, rocks, or debris to be tracked onto roadway. 8. Protect all existing underground utilities during construction. 9. It is the applicant/owner's responsibility to ensure that stormwater runoff from new L � impervious surfaces will be managed on-site in a manner that does not adversely affect ,YF® r; ; - Z neighboring properties, including the City's right-of-way and/or easements and the =77 F.' improvements located therein. 3 '`° `} .=, TIMMI Public Works Permit Fee Breakdown: "'`"- Cf) Misc. Minor Permits(Drainage Work) $25.00 PW Plan Review $20.00 PW Site Inspection $20.00 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 ,441111,4 41rift6 rr—g'- 2o1,b 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 Approved for Construction Date remove same upon notice from the City and to replace public property damaged thereby. FINAL INSPECTION Date Approved as Constructed Signa ure o App an (� 1 •1 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.