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PUBLIC /ORKS pORKS iaul <br /> 4. Date Applied: -1/14/2019 <br /> City of Everett Permit Services Publrks Permit#: PW1901-022 <br /> ._ AoommA <br /> 3200 Cedar Street, 2"d Floor Associated Bldg Permit#: <br /> Everett,WA 98201 Planning Reference#: <br /> (425)257-8810 Public Works Fee: $859.97 <br /> '23 lAll /1119 <br /> O ER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> C Fuels SC Fuels <br /> 1800 Katella Avenue, Suite 400 1800 Katella Avenue, Suite 400 <br /> Orange, CA, 92867 Orange, CA, 92867 <br /> PHONE: 7145167273 PHONE: 7145167273 <br /> TAX PARCEL ID#: SITE ADDRESS: 3217 HEWITT AVE <br /> DESCRIPTION: UST removal on private property <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 dated 01/18/2019. 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 to starting construction to set up a <br /> pre-construction consultation. All inspections must be formally requested. See the attached handout for phone number and <br /> online instructions to Request an Inspection. <br /> 6. All contaminated soil and excavated materials from the removal of the ground shall be hauled and deposited to an <br /> approved, permited site. <br /> 7. Contractor must contact traffic department contact Michael Brick 425-257-7790 to coordinate routing and time when <br /> contaminated soil is transported to approved site. <br /> 8. This permit must be finaled in order to close out this permit/grant a Certificate of Occupancy. Call the inspection line to <br /> request a Final for this permit when all items have been completed. <br /> Public Works Permit Fee Breakdown: <br /> System Development Fees Stormwater.(1,950 S.F.) $484.97 <br /> Paving (1950SF) $45.00 <br /> Erosion Control $200.00 <br /> Grade/Fill/Excavate (500CY) $90.00 <br /> PW Plan Review $20.00 <br /> PW Site Inspection $20.00 <br /> City of Everett Official Use Only- ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save <br /> C harmless the City of Everett from any and all claims for damages,costs, <br /> �„illV �i expenses,or causes of action that may arise because of installation and <br /> E°7 23 2a/" <br /> � maintenance of the improvement or other right-of-way use here to applied <br /> Ap• o"."....-for Construction (° • c Works Date for and further agrees to remove same upon notice from the City and to <br /> r e blic property dam ged thereby. <br /> FINAL INSPECTION Date <br /> Tom. _ a g -- / 3 /7 <br /> Approved as Constructed (PW Inspector) Signature of A licant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUCOMPLETEION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90-DAY DURATION. Cr--/ <br />