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PUBLICtORKS PERMIT <br /> —bate Applied: 11/21/2018 <br /> #2,•••••.1P-A City of Everett Permit Services Public Works Permit#: PW1811-042 <br /> 3200 Cedar Street, 2nd Floor Associated Bldg Permit#: <br /> Everett,WA 98201 Planning Reference#: <br /> (425)257-8810 Public Works Fee: $45.00 <br /> 2 1 N O V 2018. <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> WASHINGTON STATE DEPT OF GENERAL ADMIN SNOWDEN PATRICK <br /> PO BOX 41015 2000 TOWER ST <br /> OLYMPIA, WA, 98504-1015 EVERETT, WA, 98201 <br /> PHONE: PHONE: 4253889483 <br /> TAX PARCEL ID#: 28040200300700 SITE ADDRESS: 2333 SEAWAY BLVD <br /> DESCRIPTION: INSTALL NEW DDCVA <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 11/21/2018. <br /> 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 for a <br /> consultation and to evaluate Erosion/Sedimentation control set-up. All inspections must be formally requested. See the <br /> attached handout for phone number and online instructions to Request an Inspection. <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. It is the applicant/owner's responsibility to ensure that stormwater runoff from new/replaced impervious surfaces will be <br /> managed on-site in a manner that does not adversely affect neighboring properties, including the City's right-of-way and/or <br /> easements and the improvements located therein. <br /> 10. This permit must be finaled in order to close out this permit. Call the inspection line to request a Final for this permit <br /> when all items have been completed. <br /> Public Works Permit Fee Breakdown: <br /> Misc. Minor Permits (REPLACE DDCVA) $25.00 <br /> PW Site Inspection $20.00 <br /> NOV 2 1 2018 <br /> CITY OF EVERETT <br /> Permit Services <br /> City of Everett Official Use Only ACKNOWLEDGEMENT 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 /> L ®� 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 /> A•proved for Construction ('ubllc Works) Date for and further a•rees to remove same upon notice from the City and to <br /> replace publi pr perry damage 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 /> rade -Fi`l( * -C <br />