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CITY OF EVERETT <br /> EVERETT Permit Services <br /> WASHING TON <br /> CASH ASSURANCE DEVICE <br /> Section I -To be completed by the Owner and signed by the PW Reviewer <br /> Instructions:Complete Section and the Assurance Device License.Attach a copy of estimate of improvements <br /> and deliver all documents to the City Clerk's Office, <br /> Construction Site Address: 5001 Sound AVE <br /> Project#: PW2103-009 <br /> Name of Depositor: Ambrose'firm Kuen Chan and Cheung Wan.Me( <br /> Address: 5001 Sound AVE <br /> Phone: Email: amchan007(ahotmall.corn <br /> Check one: <br /> 0'4 Performance(installation)-Not less than 120%of the cost of the Improvements <br /> DMaintenance-Not less than 10%of estimate of improvements <br /> DOther- <br /> These funds are for the purpose of a performance guarantee for frontage improvements required as part of <br /> Short Plat SS14-005 and are to be retained for a maximum of 2 years.The projected release date is <br /> scheduled for October 2023. <br /> PW Reviewer to sign that the above warranty type and duration Information is correct: <br /> PW Reviewer Name(Printed): Thad Newport <br /> PW Reviewer Slgriature: Date: 07/13/2021 <br /> Section 11 -To be completed by the City Clerk's Office <br /> instructions:Complete the lower portion when deposit is made and route a copy to the Project PW <br /> Reviewer and the Depositor. <br /> The amount of$ 0 248.00 was deposited in the Assurance Deposit Account on <br /> (date of deposit),This transaction was completed by • <br /> GL CODE:002-239-1006-000"assurance deposit" <br /> Le//e/ <br />