1402 SE EVERETT MALL WAY SASSYS 2016-01-01 MF Import

. � - - -- -� . . Application For PUBLIC WORfCS PERMIT Print or Type Only � PUEIic WarNa Per i BIEg. Depi.+ Public Works Fee To�al Fea S Less AppL Fae Paid $ Balnnce Due S Phone Maiiing ntltlress Describe Proposed Work Project Address (it known) Zip Attach four (4) copies o� plans tor proposed work • Draw to scale and note ihe (ollowing as appticable: • Property Lines • Centerline ol street • Outline and dimensions of all existing and • Indicate N�rth proposed structures on the lot • Show any ��oposed aiading changes • Existing and proposed utilities • Show measurements PERMIT CONDITIONS 1. All calls for inspe�tion shall be made 24 hrs. in advz�ice • phone 259-R810. 2. All work shall be pedormed in accordance with this �:ermit and current City of Everett Design and Consimction Standards and Spacifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424•5555. (�LT �� ( � a�/ s Approv=d for Construction Date FINAL INSPECTIO�� Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett, WA 98201 Phone: 259-8810 ACKNOWLEDGEMENT OF CONDITIONS W H � � � H V� O a The undersi�ned owner/applicant hereby agrees to hold and save harm- less Ihe City ol Everett from any and all claims for damages, costs, expenses, or causes uf action that may arise 6ecause of installation and mainlenance of the improvement or other right•of•way use hereto applied tor and furthc�r agrees to remove same upon notice from the City and to replace public properry damaged thereby. Signature of Applicant Date WORK AU7110RIZED BY THIS PERIv11T MUST BE STARTED WITHIN 180 DAYS OF DATE ?ERMIT IS ISSUE� AN� THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. 7H�S PEFlM�T MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE Of WORK ON THIS PROJECT OVER 90 DAYS DUfiATION.