CITY OF PUYALLUP PERMITTING PORTAL

Building Division

* Final approval by the Building Official is required prior to use or occupancy.* Work shall not proceed until the inspector has approved the stages of construction.* Surface storm water shall be diverted from the building site and shall not drain onto adjacent properties.* I hereby acknowledge that I have read this Permit/Application, that the information given is correct; that I am the owner or the duly authorized agent of the owner; that plans submitted herewith are in compliance with all applicable city, county and state laws and that all construction will proceed in accordance with said laws. This permit shall expire if work is not commenced with 180 days or if the work is suspended for a period of 180 days. Permits expire two years from issuance. * By leaving the contractor information section blank, I hereby certify further that contractors (general or subcontractors) will not be hired to perform any work in association with this permit. I also certify that if I do choose to hire a contractor (general or subcontractor) I will only hire those contractors that are licensed by the State of Washington. If you are a property owner, contractor or permittee and you are paying for someone to perform the work, they must have a valid contractor registration and the person(s) installing plumbing inside a structure must meet the plumbing certification requirements. If you have any questions regarding these regulations, you may contact the Washington State Department of Labor and Industries or you can find more information on-line at: http://www.lni.wa.gov/TradesLicensing/Contractors/HireCon/default.asp

Engineering Division

SEDIMENT CONTROL AND EROSION PROCEDURES SHALL BE PRACTICED TO ELIMINATE AND PREVENT OFF SITE DAMAGE. STORMWATER RUNOFF ORIGINATING UPSTREAM OF EXPOSED AREAS SHALL BE CONTROLLED TO REDUCE EROSION AND SEDIMENT LOSS DURING THE PERIOD OF EXPOSURE. * I agree to call the Utility Notification Center at 1-800-424-5555 (811) before beginning any excavation. Call before you dig, it's the law. * I agree to cut and cap the sanitary side sewer at property line. The existing side sewer shall not be re-used. Call for engineering inspection * The applicant is responsible to decommission the existing septic system per P.C.H.D. requirements. A decommissioning certificate is required to be filed with P.C.H.D. and a copy submitted to the City of Puyallup. * The City water division shall perform the water service removal. Contact Perry Baird at 253-841-5512 to schedule. * The applicant is responsible to decommission the existing private well per P.C.H.D. requirements. A decommissioning certificate is required to be filed with P.C.H.D. and a copy submitted to the City of Puyallup. * If the existing private well is to be retained it will be necessary to install a RPBA on the domestic water service connection to the City's system. * I agree to request all required inspections prior to cover and for final inspection. I hereby acknowledge that I have read and understand the contents of this permit and I hereby state that the information I have supplied is true and correct. Indemnification / Hold Harmless The Permittee shall defend, indemnify and hold the Public Entity, its officers, officials, employees and volunteers harmless from any and all claims, injuries, damages, losses or suits including attorney fees, arising out of or in connection with activities or operations performed by the Permittee or on the Permittee's behalf out of issuance of this Permit, except for injuries and damages caused by the sole negligence of the Public Entity. However, should a court of competent jurisdiction determine that RCW 4.24.115 applies to this Permit, then the Permittee agrees to defend, indemnify and hold the Public Entity, its officers, officials, employees and volunteers harmless to the maximum extent permitted thereunder. It is further specifically and expressly understood that the indemnification provided herein constitutes the Permittee's waiver of immunity under Industrial Insurance, Title 51 RCW, solely for the purposes of this indemnification. This waiver has been mutually negotiated by the parties. The provisions of this section shall survive the expiration or termination of this Agreement.