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2 3 JUN 2017 <br /> PUBL� VORKS PERMIT Date Applied: 5/11/2017 <br /> '. ; City of Everett Public Works Department Public Works Permit#: PW1705-020 <br /> 3200 Cedar Street Parent Permit#: C1701-022 <br /> Everett,WA 98201 Planning Reference#: <br /> (425) 257-8810 Public Works Fee: $65 <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> FITZGERALD HAL D & DORIS DIMICO JOE <br /> 3811 121ST PL SE <br /> EVERETT, WA, 98208 <br /> PHONE: PHONE: 4257720694 <br /> TAX PARCEL ID#: 28050500206500 SITE ADDRESS: 5527 BROADWAY <br /> DESCRIPTION: NEW SFR DETACHED <br /> THIS PERMIT IS FOR INSTALLATION OF SEWER, WATER, AND DRAINAGE CONNECTIONS FOR THIS LOT. <br /> LOT 2 OF COE SP 1202-2004-12 <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. Install erosion control measures as determined by the Public Works Inspector, such as silt fence, straw bales, swales, or <br /> erosion blankets. <br /> 5. Connect rooftop downspouts to the drainage system provided for this lot. <br /> 6. Connect side sewer per City Standard#601. <br /> 7. Contact the City of Everett Public Works Inspector Randy Allen at 425-339-7403 prior to starting construction and with <br /> other inspection requests. See attached to request an inspection. <br /> 8. Site Civil Work to be done per plans approved by the City of Everett Public Works Department dated 01/31/2006 and <br /> 05/11/2017. <br /> Public Works Permit Fee Breakdown: I] JUN 2 <br /> Misc. Minor Permits $25.00 3 201? fp <br /> PW Plan Review $20.00 <br /> PW Site Inspection $20.00 CITY OF EVERltbv''►' <br /> City of Everett Oficial Use Only ACKNOWL BIYI�N rake I-fIONS <br /> The undersigned owner/applicant hereby agrees to hold and save <br /> � f f harmless the City of Everett from any and all claims for damages,costs, <br /> Aopi <br /> / I expenses,or causes of action that may arise because of installation and <br /> maintenance of the improvement or other right-of-way use here to applied <br /> Ap oved for Construction (Public Works) ate for and further agrees to remove same upon notice from the City and to <br /> replace public property damaged thereby. <br /> FINAL INSPECTION Date <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 />