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( _ C) <br /> � PUBLIC WORKS PERMIT °"° <br /> PUBIJC WORK3 DEPARTMEM Publle Worke Parmlt• <br /> 3200 Cedv Stnst <br /> Evaretl,WA 88201 258-8810 BWldinp PertnN A <br /> NPE OR PRINT ONLY PuNk Nbrb Fss: <br /> Pplp�n Ch�ck No: 8 6/0�8/5 SLPA <br /> �� � JobcAddr���s 24272�6DAR 8T �s <br /> Own�rr REID BFRRRY <br /> T�nant� <br /> Applicent Propo��d U��s Phone <br /> D��c. of Mork� <br /> N6M D6TACH6D 6ApAO6 <br /> Describe Proposed Work __ I � � <br /> OT�ICZ BtT JOB 86T Y� <br /> _ 11PPAOV6D !OA P6AMITt DATE�/_/_ BY � <br /> � <br /> � <br /> PROJECT ADDRESS Qf known) � <br /> Atlach four(4)c»�ba of plans fa proposed worl:-Orew to acals end note tM folbwlnp M�ppllceWe: O <br /> `Property IJnea 'Outline�nd dimanabne ot ell e�ietinp and propoeed atnielurse on ths bt �Exlatirp end propoeed utltHlas <br /> 'CentMine of atrost Mndkate North 5how eny propoesd pndlnp ehanpa �Show msaswamante � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: Z <br /> 1.All calls for inspection shall be made 24 houra in edvance-phone 259-8810. O <br /> 2.All work ahell be performed In eccordance with thls pertnit end current City of Everett Design end <br /> Construction Standards end Speciflcatlons. <br /> 3. Call Location Underground Service 4B hrs. before you dig. TOLL FREE NUMBER 1-900-424-6665. � <br /> � <br /> O ' <br /> a <br /> ?UQLIC WORKS �ERM�� <br /> NOt REUUIR�� <br /> �Y_.� II <br /> �nTr.__J �---- <br /> ACKNOWLEDOEMENT OF CONDITIONS I <br /> The undanlpned ownar/epplieent Mrehy�,rses to hold end+eve humM�� '�i <br /> ths City o1 Everatt fiom any and all c W ms la darnepes,wets,expsn�es,a ��� <br /> Approved for Conetructlon pe�s eeuaas of ectbn thet mey eAas bscausa ol Inetall�tbn and melMenanca M I <br /> tMY�provanantaotMrrqht-of•wayussheMo�pplledforendhMMrgMs � <br /> to removr eame upon notks han 1M CHy and to raplace pubNc propMY <br /> demeped Ihareby. <br /> FINAL INSPECiION Date <br /> Approvad as Conatructed <br /> Sipnaturo ol Applkant Dtla <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STAHTED WITHIN 180 DAYS OF DATF PERMR IS ISSUED AND THERF.AFTER IS TO BE DILIQENTLY PURSUED TO <br /> COMPLETION.THIS PERMR MAY BE CANCELLED BY THE CI1V UPON ANY STOFPAOE OF WORK ON 7MIS PROJECT OVER BO DAYS W RATION. <br />