709 N BROADWAY 2016-01-01 MF Import

TYPE OR PRINT ONLY Owner Apphcytion For PUBLIC WORKS PERMIT PUBUC WORKS DEPARTMENT 3200 Cedar Street Everett, WA 98207 259-8810 �1 C Mailing Ad �a�£ Address � Describe Proposed Wcrk ` A PROJECT ADDRESS (if known) , � d�vES, City Attach tour (4) copies of plans for proposeA work - Draw to scale and note the following i} applicable: Date �� / Public Works Pertnit R _ ��-3 Building Permit A -- 3.�"�-= Public Works Fee $ J tjB c-2� _ 98to8 �1�8-5�1 lZ. up Phone •Pmperty Lines •Outline and dimensions of all existing and proposed structures on the lot •Exisling and proposed utilities •Centedine of sireet •Indicate NoAh `Show any proposed grading changes •Show measurements Co„��- DO NOT WRITE BELOW THIS LINE PERMIT CONDITIONS: 1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. 2. All work shall be performed in accordance with this �ermit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � Gt �.�,� � .�iZ �-hf ,,, ��-�� < � F'- ��o,� ��-�_ c/ � j,7 <C'�/y � �� /;c� ;,�� ,� �C�� /IRn � � f1 �99� °�r�"'�;: �... a::,�� °�• E��R•�..,,. ." �,V.y; er% ~. �., W H — V) � O � ACKNOWLE�GEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harmless �he City of Everett trom any and all claims tor damages, costs, expenses, or causes of action that may arise becai�se of inst:.11ation and maintenance of the impro�ement or other ngM-ol-way use hereto applied for and futlher agrees to remeve same upon notice 1rom ihe City and to replace public property d.,maged thereb � � 9� Signature ot A icenl Date WORK AUTHORIZED BY THIS P[RMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AN EREAFTER IS TO B[ DILIGENTIY PURSUED TO COMPLETION. TFiIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPPGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.