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PUBLIC RORKS PERMIT Date: 4/18/2017 <br /> r Public Works Permit#: PW1704-026 <br /> City of Everett Public Works Department <br /> J 3200 Cedar Street Parent Permit#: CI702-006 <br /> ' Everett, WA 98201 <br /> Planning Reference#: <br /> (425)257-8810 <br /> Public Works Fee$: $ 65.00 <br /> Other$: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> GASHU MULUGETA&ABEBE KEFAY <br /> 10123 MERIDIAN AVE <br /> EVERETT WA 98208 <br /> PHONE: 2063063229 PHONE: <br /> TAX PARCEL ID# 00396900003802 SITE ADDRESS: 10123 MERIDIAN AVE <br /> NEW ADDITION FOR ADULT FAMILY HOME <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. <br /> 3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 <br /> 4. Site Civil Work to be done per plans approved by the City of Everett Public Works <br /> Department dated 4/18/2017. <br /> 5. Contact the City of Everett Public Works Inspector Jim Knappert at 425-339-7404 W <br /> prior to starting construction and with other inspection requests. [11 <br /> 6. Install erosion control measures per City of Everett Standards for small parcels and l� <br /> remove upon completion of the project prior to final approval of the permit. CA <br /> 7. Keep City streets clean at all times. No dirt, mud, rocks, or debris to be tracked onto <br /> PO <br /> roadway. O <br /> 8. Protect all existing underground utilities during construction. <br /> 9. It is the applicant/owner's responsibility to ensure that stormwater runoff from new <br /> impervious surfaces will be managed on-site in a manner that does not adversely affect 'Z <br /> neighboring properties, including the City's right-of-way and/or easements and the O <br /> improvements located therein. <br /> Public Works Permit Fee Breakdown: s'q)) <br /> cr <br /> Misc. Minor Permits $25.00 MAY 0 5 2017 J 0 <br /> PW Plan Review $20.00 <br /> PW Site Inspection $20.00 Qi <br /> CITY OF EVERETT <br /> Permit Services <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> 44The undersigned owner/applicant hereby agrees to hold and save harmlesst SeCity of Everett from any and all claims for damages,costs,expenses,or <br /> Ø8/ & causes of action that may arise because of installation and maintenance of the <br /> Approved for Construction Date improvement or other right-of-way use hereto applied for and further agrees to <br /> remove same upon notice from the City and to replace public property <br /> damaged thereby. <br /> FINAL INSPECTION Date --- <br /> Approved as Constructed Si nature of Appli nt Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY <br /> PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br /> 6 <br />