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Date 9I19/2012 <br /> PUBLIC W(yRKS PERMIT public Works Permit # PW1209-017 <br /> C !y of Everett P�51ic Works Department guildinp f efmit #, <br /> � � � ,, , 3200 Cedar Street <br /> �/ ' �' � Fveretl. WA 98201 plonning Reference# <br /> �.� , (425)257-9810 <br /> Public Works Fee $ 5 25 GO <br /> Other $ _ <br /> OWNER NAME AND ADORESS: I APPLICANT NAME AND ADDRESS: <br /> COUNTRY Cl UB PR[iERVAI ION �OYS& GIRLS CLUB <br /> �IBO PINF Sl FL 16 9502 19TH AVE SE#F <br /> [VERETT WA 98208 <br /> SA�' CA 94111 <br /> FRANCISCO PHONE: 4252527700 <br /> PHONE: ____. <br /> TAX PARCFL ID M 28051900101 A00 SITE ADORESS: 1302 100TH PL SE <br /> DESCRIPTION OF PROPOSED WORK� <br /> f-.XPANSION OF FXISTING f3ASKFTC�ALL COl1RT-TRAILSIDE VILLAGE APT <br /> PFRMIT COt:DITIONS <br /> t All calls for inspection shall be made 24 ha�rs in ad�ance <br /> 2 All work shall be performed in accordance with lhe permii and current City oi Everett Design and Construction Standards <br /> and Specitications. --- <br /> 3 Call Localion Underground Service 48 hrs before you dig TOLL FREE NUMBER 811 <br /> 4 Per SPU 12-007 <br /> Yo�ir Puhlir WorYs Irsneclor is Chf( I indman Call him at 425-339-7404 for quesbons and insper,hcns � <br /> F <br /> � <br /> O <br /> � <br /> O <br /> � <br /> O <br /> o. <br /> ACKNOWIEDGEMEN 1 OP CONDITIUMS <br /> I be und���siyned ownerlapphcanl hereby agrees to hoiJ and <br /> _ __. __._. _____— savr�I�annless Ihe City ol Everetl from any end nll d�ums lur <br /> - -----' - - - �-� � � �� dambges,wsls, expenses,or cnuses of ection that may ar�se <br /> , / beceuse of inslallation and maintenence o1 ihe improvement <br /> ��� �� (�/'. ,_//�, /' or o�her righ�-o6wey use herelo applied for and luriher agrecs <br /> + � ' � � � �� � �'" o remove same upon nollce from the City and to replace <br /> �pproved for Construction Date public properly demaged Ihereby <br /> � . / ���� -� ' - _ � � ! � lD �l � ?UIL <br /> f��Al Sf'FCTIO Oate � <br /> !M(7p�Oved 85 ConsUucled Signelure ol Applicant Date <br /> W(�RK AUfNORVfU IfY 7HI5 PFP^11i hiU;T Ilf SiARiEU WITHIM 190 DAYS nr UAI�C �'FR141T IS ISSU[D AND TII[:RFAFIFR IS TO BE DILIGENTLY <br /> PI Ili;UI U I�l CO'41'I 1 t li�'+ I I il�. �" °'II 1 '.�4� Pf ��^�I(ll I I D Hv I Nf t I�Y uPUN AF1' ;IOPPPGI.OP AYORK GN 11115 PRO)ECT OVFR 90 DAYS DURATION. <br />