2718 W MUKILTEO BLVD 2018-01-02 MF Import

in W gia74 1 _3(E.7 Application For !NI F ,' c[ P7 PUBLIC WORKS PERMIT Date j PUBLIC WORKS DEPARTMENT 8.6, Public Works Permit# CI 7,,/ 4.1 3200 Cedar Street Ill Everett,WA 98201 259-8810 I L) Building Permit# TYPE OR PRINT ONLY Public Works Fee$ ' ' ....1c , e� -tom, k,.;,v., s t.- ENi'k? + q C4C"" --7 �5�- C Sial,2, _ Owner Mailing Address suety Zip Phone Applicant Mailing Address i:l.. t± i"' City Zip Phone Describe Proposed Work ',era.. `>4 ' \ \'"wa-:C. '1 4'''- -- ws-4.., c. .� W. � `z e. .—'. �f? )5 k 5 - 'i ewe PROJECT ADDRESS(if known) -t'---2.._ Attach four(4)copies of plans for proposed work-Draw to scale and note the following if applicable: •Property Lines 'Outline and dimensions of all existing and proposed structures on the lot 'Existing and proposed utilities O 'Centerline of street 'Indicate North 'Show any proposed grading changes .•Show measurements DO NOT WRITE BELOW THIS LINE PERMIT CONDITIONS: Z 1.All calls for inspection shall be made 24 hours in advance- phone 259-8810. 2. All work shall be performed in accordance with this permit and current City of Everett Design and 0 Construction Standards and Specifications. 3. Call Location Underground,Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. Isom 7 v, e erosito 0o r-o1 )iccck.,eJ }11.-cm.k r ,s CO 14 6I r , el IUCIsrl(A net - - 1iii4e d - t ± lie t.icc.. o `' Ow i 0 (A.)e '"(yid d e S 5 li0c.) vi 01 c- io of Ft ci+ 04Al) 12OZ- 7- 9 . vice A K--:.t N'i e f 1/1 C- 4.0 e+r c.e edt `! . t,v't . `V 11 i L.; M i-kd 60 56 J r s �4: -I. ,, s -L. �-6 -� j2P(t c , f.- c�b-i r e v Fev' �i f- rod' 1 11 'r'A excas S O-r 56 •- v:1) 1 Dzio ‘3G 2)2'991 ACKNOWLEDGL�MENT OF CONDITION The undersigned owner/applicant=hereby.agr.ees•to' ' la -ind save harmless �' ;� — s the City of Everett from any anti,.�#t•ctai ford ,costs,expenses,or f- ----e."';. = �� causes of action that may arise(9k�ls .of intlititiatand maintenance of "prov'`Approved for Constf t' / Date O to applied for and furtherer agrees ed�� the improvement or other right-of-vu g� pp' g to remove same up w notice'-from the City and to replace public property damaged thereby. 1 * FINAL INSPECTION Date Approved as Constructed `,, j ', ) F -'') Signature of Applicant _:__ Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED'WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS.TO BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT.MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.