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PUBLIC �ORKS PERMIT <br />City of Everett Public Works Department <br />3200 Cedar Street <br />Everett, WA 98201 <br />(425) 257-8810 <br />� Date: 11 /21 /2014 <br />Public Works Permit #: PW1411-040 <br />Buildinq Permit #; B1411-037 <br />Planning Reference #: <br />Public Works Fee $: $ 40.00 <br />Other $: <br />OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br />BUSCH EDWARD JOHN <br />1016 9TH ST <br />ANACORTES Wq 98221 <br />PHONE: PHONE: <br />TAX PARCEL ID # 28041300100100 SITE ADDRESS: 8500 EVERGREEN WAY <br />DESCRIPTION OF PROPOSED WORK: . <br />PUBLIC WORKS FOR DRIVE-THRU-BANK OF AMERICA <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hours in advance. <br />2. All work shail be performed in accordance with the permit and current City of Everett Design and Construction Standards <br />and Specifications. <br />3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 � <br />4. Per approved plan. <br />✓ ` ����� � <br />� <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />a._... �_._. i� r__� ,._,� ;_� ;_. <br />1.`�-i -r�7 -'n �7. �J"J -�� i� a -:� -n r-ry <br />r— x- :� �-. s;. .._., r— � <br />S. �J�.iT+ _r.IS�C� <br />?'7 i--i -a'� 1,=7 �' i� I <br />�- � <br />t�.a ' r�j r..f"'.._ �.__..� <br />r- _-- <br />��� <br />f <br />�° <br />�4hi� <br />��� <br />;;F,t 4d� I--� 1 • PJ� <br />•C95} i:fk -C>• • EF:+ O� <br />•.�ir � I' •.� f il I—� a�=.t �:� . f�JCe '-i! LT7 <br />L.� ��� C� r.,7 I—�. y. _W, e �. .; `. �. <br />G } a <br />tt"•. P'x Y_T ti�f .G.`. Y"1 Y?� x ITTi 4.Y•• <br />_G• '*° .=? G:: a C) C) '�� ^ :._� �I �ti••. <br />r �; �.� � r '°:� <br />� �� � <br />n I��/�I <br />� ` Vl <br />F- h+�l <br />r�• <br />L�A :�.'7 :: 'o <br />-7 �7Ci1 O <br />I .) ` <br />�����' J <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and <br />save harmless the City of Everett from any and all claims for <br />damages, costs, expenses, or causes of action that may arise <br />because of installation and maintenance of the improvement <br />or other right-of-way use hereto applied for and further agrees <br />to remove same upon notice from the City and to replace <br />public property damaged thereby. <br />( G� �u�l/ 4 , �����7 "' � h - 7 ;� _ � �� <br />Signature of Applicant <br />Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY <br />PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />