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PUBLIC SORKS PERMIT —bate Applied: 12/13/2017 <br /> City of Everett Public Works Department Public Works Permit#: PW1712-027 <br /> 3200 Cedar Street Parent Permit it C1712-008 <br /> f <br /> Everett,WA 98201 Planning Reference It <br /> (425)257-8810 Public Works Fee: $85.00 <br /> 22 JAN 2018, <br /> OWN NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> D SUNMU LUGBENGA DOSUNMU LUGBENGA <br /> , t , t <br /> PHONE: 2063712266 PHONE: 2063712266 <br /> TAX PARCEL ID#: 00495000100400 SITE ADDRESS: 6007 ROCKEFELLER AVE <br /> DESCRIPTION: CONCRETE WALK FOR ADULT FAM HOME CONVERSION <br /> STATE REQUIREMENTS/CONVERT DINING ROOM TO BEDROOM <br /> THIS PERMIT TO BE POSTED ON JOB SITE AT ALL TIMES <br /> PERMIT CONDITIONS: <br /> 1. All calls for inspection shall be made 24 hours in advance. <br /> 2. All work shall be performed in accordance with the permit and current City of Everett'Design and Construction Standards <br /> and Specifications for Development'. <br /> 3. Call Location Underground Service 48 hours before you dig. The day you call does not count. TOLL FREE NUMBER 811. <br /> 4. Site Civil Work to be done per plans approved by the City of Everett Public Works Department dated 12/13/2017. <br /> Approved plans must remain on job-site at all times. <br /> 5. Contact the City of Everett Public Works Inspector Randy Allen at 425-339-7403 prior tp..st•.arting cQstructi I fob 9'' <br /> consultation, to evaluate Erosion/Sedimentation control set-up, and with all other insp cti94.fequgs$,s....„^: <br /> 6. Install and maintain erosion control measures per City of Everett Standards and p',�;tFieriii:Ctio"' n K 'PW Inspector. <br /> Remove upon completion of the project prior to final approval of the permit. `7'1 _ <br /> 7. Keep City streets clean at all times. No dirt, mud, rocks, or debris to be tracked onto roadway. <br /> 8. Protect all existing underground utilities during construction. <br /> 9. Inspections must be requested for concrete formwork prior to pouring concrete and after concrete has been pourrdN <br /> Public Works Permit Fee Breakdown: 1'J t:�a <br /> Paving (241sf concrete walkway) $45.00i'ri <br /> PW Plan Review $20.00 1 <br /> r•._) r..t t'•,:7.a::. <br /> PW Site Inspection $20.00 :-_ <br /> -.,0x' rs <br /> D :0 Via.-_j CDC) •.::) w <br /> ...moi. •.q:i <br /> {"•o <br /> City of Everett Official Use Only ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save <br /> )1tiaiut_ harmless the City of Everett from any and all claims for damages,costs, <br /> C 2,/;3/ expenses,or causes of action that may arise because of installation and <br /> maintenance of the i ; vement• or other right-of-way use here to applied <br /> Approved for Construction (Public Works) e for and further agr:-s to re, ove same upon notice from the City and to <br /> replace public prop:rty dam.29ed thereby. <br /> FINAL INSPECTION Date <br /> 2.z/ 8' <br /> Approved as Constructed (PW Inspector) Signature of Ap icant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLETEION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90-DAY DURATION. <br /> F <br />