7815 EVERGREEN WAY NORTHWEST FINANCIAL 2016-01-01 MF Import

Date�� Applicalion For PUB�.IC WORKS PERNiIT Print or Type Only Mailing Address �' -� I PoClic Works Pcrmil a BIEg. Dopt. s Public Ylo�kS Fee 5 Toial Feo Less AOCL Fao Pa10 S Balanco Oue S Fhone � � �� �--! Applicant Mailing Address City Zip Phone Describe Proposed Work I�d�i�� ( �U�� f"• Prolect Address (if known) Attach low (4) cop�zs of plans for proposed work • Draw to scale and note the following as applicable: • Property Lines • Outline and dimensions o( all existing and proposed structures on the lot • Existing and proposed utilities PERMIT CONDITIONS • Centerline of street • Indicate Norlh • Show any proposed grading changes • Show measurements 1. All calls for inspection shall be made 24 hrs. in advance - phone 259•881 5. 2. All work shall be performed in accordance with this permit and current Ciry of Everett Design and Construction Standards and Specilications. 3. Call Locztion Underground Service 48 hrs. beforc you diy. TOLL FREE NUMBER 1•S00•424•5555. Approved for Construction �l n. � �r�-�u��2� /2� s �' �� ACKNOWLEDGEIv1ENT OF CONDITIONS � � � � O '�A M♦ O a The undersigned ownedapplicant hereby a�raes to hold and save harnr less the City ol Everett Irom any and all claims lor damages, costs, expenses, or causes nl action that may arise because ol installalion and maintenance of the improvement or olher right�ohvray use hereto applied tor and further agrees to remove same upon notice trom the Date City and to replace public property damaged thereby. FINAL INSPECTION Date Approved as Construcled everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Streel Everett, WA 98201 Phone:259-8815 Sic�nature of ApPlicanl Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTE�7 IS TO BE DILIGENTLY PUfiSUED TO COMPLETION. THIS PERMIT MAY BE C,4NCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURF�TION.