2405 BAKER AVE 2016-01-01 MF Import

Applicalion For � / PUBLIC WORKS PERMIT ��1e �lZ8��t7 � PUBLIC WORKS DEPARTMENT Public Works Permit k —�L/I�+--/-- 3200 Cedar Street Everett,WA 98201 259-8810 Building Permit H _ _ TYPE OR PRINT ONLY P.ihlic Warks Fee$ � + _ _ " v.uc l��-hnQ�e� �-�105 ES��t� /�� vc�c-e.t� `t9Zo� 33�t- `Z�T� Owner �vlailing Address C:ty 2ip Phone �a�t v.�r. '�tc-�v. Z'1oS 13a.�ce� 14v< E�c�cl'�' 98Z.�� =,'Sy–�10,Z `1 -- Applicant Mailing Addross City Zip Phone Describe Proposed V'Jork T o c t Q o w� w�� E-`, c o t. crc.�2 � � �i�Vt W4Y �QQ'C04G� �Olv� CtX�C OT S ��SWu\ R CO � _� f� � re�uh � aT ..�4��t — _ ♦A V/ PROJECT ADDRESS(if known) ? `t o 5 3�Ec.�c � .+-L __ � Aflach lour(4)copias of plans for proposed work-Urew tu scale and note the lollowing if applicable: O •Property Lines 'Outlina and dimunslons of all existing and proposed structures on ihe lot •Existinq and proposed utilities •Centerline ol street •Indicate North •Show any proposed gratling changes •Show me��urements � DO NOT WRITE BELOW THIS LINE PERMIT CONDITIONS: ps/?g/g7 1^c�OOFM OOC�q140 �kK ?. All calls for inspection shall be mede 24 hours in advance- phone 259-8810. O 2.All work shall be performed in acc�rdance with this permit and current City of F��sign and Construction Standards and Specifications. „ 3. Call Location Underground Service 48 hrs. before you dic�. TOLL FREE NUM�=800-��.�55. � � �s �,,- p�b�,� �,� ;,��,�-s d;�;� ,�,��r� O a ACKNOWLEDGEMENT OF CONDITIONS �� The undersigned ownedapplicant hereby agrees to hold and save harmless lhe City ol Everett from any and all claims lor damages,costs,oxpenses,or proved lor on mcy' D causes oi action thal may a�ise because oi installation and maintenancc of the Improvement or other right-oi-way use hereto applied lor and turiher agrees � /� to re.move same upon notica fmm the City and to replace public property ' �� damaged iherehy. F!NAL I P CTI Date n Approved as Consiructed f��` //� /' vl/ S-ZS- R7 Signature of Applicant Data WORK AUTHORIZED BY THIS PERMIT MUST BE S��ARTED WITHIN i80 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS T��BE DILIGENTLY PURSUED TO COMPLETION.THIS PEIiMIT MAY BE CANCELLED BV THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 CAYS DURATION.