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PUBLIC*ORKS PERMIT =ate Applied: 10/20/2017 <br /> City of Everett Public Works Department Public Works Permit#: PW1710 032 <br /> 3200 Cedar Street Parent Permit#: B1710-039 <br /> Everett,WA 98201 Planning Reference#: PREAPP17-030 <br /> (425) 257-8810 Public Works Fee: $1384.62 <br /> 2 8 DEC 2017 <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> EPC HOLDINGS 908 LLC GABBERT ARCHITECTS <br /> 2001 WESTERN AVE SUITE 330 20011 BALLINGER WAY NE <br /> SEATTLE, WA, 98121 SHORELINE, WA, 98155 <br /> PHONE: PHONE: 063673600 <br /> TAX PARCEL ID#: 00445600003100 SITE ADDRESS: 10627 19TH AVE SE <br /> DESCRIPTION: CONSTRUCT COMMERCIAL BLDG (DENTAL OFFICE) <br /> THIS PERMIT COVERS SITE WORK INCLUDING SEWER, WATER AND DRAINAGE CONNECTIONS. PERMIT ALSO <br /> INCLUDES STREET IMPROVEMENTS AND PARKING LOT <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, SWPPP, and drainage report approved by the City of Everett Public Works <br /> Department. Approved plans must remain on job-site at all times. <br /> 5. Contact the City of Everett Public Works Inspector Jim Knappert at 425-339-7404 prior to starting construction to set up <br /> a pre-construction consultation.All inspections must be formally requested. See the attached handout for phone number <br /> and online instructions to Request an Inspection. <br /> 6. City of Everett Water Department crews shall make all connections to City water main at owner/contractor's expense. <br /> 7. As-builts of storm, sanitary sewer, and water systems will be required to be submitted to the PW Inspector per City <br /> Design and Construction Standards and Specifications for Development prior to final approval/close out of the permit. <br /> Public Works Permit Fee Breakdown: <br /> Paving (9350SF) $46.75 $ A <br /> Erosion Control $200.00 <br /> PW Plan Review $379.29 <br /> PW Site Inspection $758.58 D� 2017 <br /> CITY OF EVE1Er <br /> City of Everett Official Use Only Permit SerViCeaCKNNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save <br /> harmless the City of Everett from any and all claims for damages,costs, <br /> /2^ /7 expenses,or causes of action that may arise because of installation and <br /> maintenance of theimprovement or other right-of-way use here to applied <br /> Appro d for Construction (Public Works) Date for and fu er agres to remove same upon notice from the City and to <br /> replace p 'c prop dap sed thereby. <br /> FINAL INSPECTION Date J tO ^2 �/ <br /> Approved as Constructed (PW Inspector) 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 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 /> > e- <br />