3905 BROADWAY 2016-01-01 MF Import

. � PUBLIC WORKS PERMIT Date: 10/1/2012 Public Works Permit#: PW1210-001 , City of Everett Public Works Department Buildinq Permit#; 3200 Cedar Street � ` 5`� Everett, \NA 98201 Planning F.eference#: (425) 257-6810 Fublic Works Fee g: $ 35.00 Other $: OWNER NAME AND ADDRLSS: APPLICANT NAME AND ADDRESS: PELLCO CONSTRUC7lUN PELLCO CONSTRUCTION 13036 BEVERLY PARK RD 13036 BEVERLY PARK RD MUKILTEO WA 98275 MUKILTEO WA 98275 PHONE: 4257761335 PHONE: 4257762335 TAX PARCEL ID# SITE ADORESS: 3905 BROADV�'AY AVE DESCRIPTION OF PROPOSED WORK: BORE ACROSS BROADWAY ISSUED PER GW PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hours in advance. 2. All work shall be performed in accordance with lhe permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 4. Per traffic control plan. E"� � � �. O ti z 0 F � O a ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harmless the City o(Everetl irom any and all claims for � damages, costs,expenses,or causes of aclion thal may arise Ibecause of inslallalion and mainlenance o(the improvemenl , � �,� .. �L� or other righbof-way use hereto applied for and further agrees � lo remove same upon notice from lhe City and to replace App� •e t �.COnsl � i6 D te ^ Fublic property damaged thereby. c.�c-;1��-f�- -.C_ ��-�`�- �� Z G /-/2 F�NA INSP CTION Date Approved as Constructed ignature ot Applicant Dat� WORK AUTHORIZED DY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS F DATE PERMR IS ISSUED AND THEREAFfER IS TO BE DIUGENTLY PURSUED TO COMPLET70N. 7HI5 PERMIT MAY BE CANCELLED BY THE QTY UPON ANY STOPPAGE OF WORK ON THIS PROJECi OVER 90 DAYS DURATION.