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c: <br />� <br />PUBLIC- WORKS _- <br />PERIVIIT ,_� <br />'. <br />OWNER NAME <br />AND ADDRESS: <br />�? T <br />PHONE: <br />TAX PARCEL I.D.# <br />DESCRIPTION OF <br />PROPOSED WORK: <br />PERMIT CONDITIONS <br />PUBLIC WORKS;DEPAFiTMFJ�T <br />3200 Cet�ar Street ` �` <br />, <br />Everett, WA 98201. <br />(425) 257-88�0 i_ <br />� <br />- ';';;: <br />— — ��� ` <br />_ _i t��� <br />� �. F..I �� f �r �: <br />... ..�. ..._" <br />��i'��I' <br />'r. �i4.f_t . <br />�7',_,.,��'- <br />i <br />APPLICANT NAItAE'�' <br />AND ADDflESS:'''::: <br />i <br />i ��' <br />PHONE: ' — <br />PROJ�C7:qdD�€�S: <br />Date <br />Public Works Permit # `=' 0- Q�;. � <br />Building Permit # �"`'' <br />Planning Reference # <br />Public Works Fee $ <br />Guarantee $ <br />S ' � � � hJ / U � I ; ..` , <br />t, � E <br />!-, :��1 � U.�� I� �; ^�s � �: <br />1. All calls for inspection shall be made 24 hours in advance. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555 <br />- _.: _ ;� �_ �..: � _�. F--.__ �_ .._.._ ...._ _.... <br />, _, _ <br />�.,: : <br />t.��c1:1Pl�C(� i:;�L11:3.d1ry �:ri'�.G�L t;C'� jeFtY:.�1l93.[T�� t;�lt? ��,t�c�P�t;. <br />E. �tz.t��,l er�'�1'7_��,x� C'r_�ntr�r�l 3Ys�,aSt.1�•�u �e�Y� �"it� t�� Euer�tt •3fi�n�la�'�.1� f <br />�. i'�O �l�t� E4i1�{, r:��-�J -- `-�=`;:•Z;:7 }Q �:�' tL.�C'kpr� nP+,::� r�,;�,�:�'aT3��, <br />S. P.�;.�. ,_l��;reEa�y fic�m t.ne ii•�=nt - _. - : - - �,. � <br />9. A s�:�L'it1}:ler sy�tein i;, r���i.�ic� <br />req�airernent�: r,f NFFA Standar��3s ' <br />Fi:�r; Prrp,? Tr •Tsie;�_T,'K=' rx�.^, �"rm_ . :' � <br />�C��:�.�-� es ���e•� y� '� �-� �=L ��%s �� ��!JlJ��4: �( �ti `� ;�« -��`<� <br />� � <br />��.� c;��� a � �-�,�.�� ,--� ��,� �.y d� ��,��G � � � � ��;�;v� � , �- <br />� �[.. 'i�t_� ✓ �"C.��-J�F��G �'c_9 Ci/ I �) `� <br />h � <br />>'Y�vs�- S�����7'`' ��IS�T� �%l'13c� �u����4> _. <br />✓ <br />� <br />�. �'j.: , y, ��1 �! �' � <br />�pproved for Construction Date <br />i <br />�''',i%'.Ay-'��i�� -- ---- <br />L INSPECTION <br />Approved as Constructed Date <br />.� _G,� _�� <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 or <br />other right-of-way use hereto applied for and further agrees to <br />remove same upon notice from the City and to replace public <br />property damaged therek4�. <br />,� ,� .� �, <br />��% _ � �';;���,�-!�--_ <br />Sign9ture of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED <br />TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />EPWP (7/06) DATABAR, INC. <br />