1402 SE EVERETT MALL WAY PURDYS CHOCOLATES 2018-01-02 MF Import

Date �E 11 s Application For PUBLIC WORKS PERMIT Print or Type Only Applicant Mailing Address Describe Proposed Work �n0(%CL! / 0✓-1 Project Address (if known) City City Zip Public woos Permit s Bldg . Door . Public Works Fee Total Fee 5 — Less APPI Fee Paid 5 �— Balance Due $ _— Attach four(4) copies of plans fur proposed work - Draw to scale and note the following as'dpplicable: O Property Lines O Centerline of street O Outl.ne and dimensions of all existing and O Indicate North propused structures on the lot O Show any proposed grading changes O Existing and proposed utilitie n O Show measurements Phone PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hrs. in advance - phone 259-8810. 2. All w-rk shall be performed in accorcance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground:.ervice 18 hrs. before you dig. TOLL FREE NUMBER 1-800.424-5555. Approved for Construction Date FINAL INSPECTION Approved as Constructed PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett WA 98201 everett Phone: 259-8810 ACKNOWLEDGEMENT OF CONDITIONS W 0 z O O am The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett from any and all claim; for damages, costs, expenses. or causes of action that may arise because of installation and maintenance of the improvement or other right-of-way use hereto applied for and further agrees to remove same upon notice from the City and to replace public property damaged thereby Signature of Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARIED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.