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PUBLIC WORKS PERMIT � Date: 8/1/2012 <br /> Pubiic Worics Permit#: PW1208-001 <br /> Ciry of Everett Public works Department guildinp Permit�; U1205-013 <br /> 3200 Cedar Street <br /> Everett, WA 98201 Planninp Reference#: <br /> (425)257-0810 ,y.p <br /> Public Works Fee S: $ ��0 a5• — <br /> Other $: <br /> 01YNER NAME AND ADDRES3: APPLICANT NAME AND ADDRESS: <br /> HGEKSTRA MATTHEW 8 DANAE SOUTH COUNTY PLUMBING <br /> 1732 COLBY AVE PO BOX 6157 <br /> EVERETT Wq gg201 EDMONDS WA 98026 <br /> PHONE: 8587051167 PHONE: 4257757377 <br /> TAX PARCEL ID N 004380346D7702 SITE ADDRESS: 1732 COLBY AVE <br /> DESCRIPTION OF PROPOSED WORK: <br /> ADD BACKWATER VALVE-OUTSIDE OF BUILDING <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection shall be made 24 hours in advance. <br /> 2. All work shall be performed in accordance with the permit and current City of Everett Design a�d Construction Standards <br /> and Specifications. <br /> 3. Cali Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 611 <br /> 4. For inspections call Public Works Inspector Randy Allen at 425-339-7403 <br /> H <br /> � <br /> � <br /> Qa <br /> 0 <br /> ti <br /> z <br /> 0 <br /> F <br /> � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold end <br /> save harmless the City of Everett from any end all cleims tor <br /> � damages,wsts,expenses,or causes of adion thet may arise <br /> , __-� becauae of installation and maiMenance of the improvement <br /> � � �/� or other right-of-way use hereto epplied for and fuAher agrees <br /> —7 to remove same upon notice from the Ciry end to replace <br /> Ap for onstru � Dat public property damaged thereby. <br /> ,� �_�,- �Z <br /> FINAL INSPEC ION Date \�— � � � ^ �2 <br /> Approved as onstructed Signature of Applicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMTT IS ISSUED AND lHEREAF7ER IS TO BE DILIGENTLY <br /> PURSLIED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY iHE CffY UPON ANY STOPPAGE OF WORK ON lHiS PRO)EC70VER 90 DAYS DURATIOFL <br />