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

( Date�=�� qppifcation For � PUBLIC WORKS FERMIT Frint or Tyoe Only �Aailing Describe ProPosed Work Prolect Address (if known) Sf \ ublic Woiks Permlt + amy. oeo�� • PublicWo�kSFne S Totel Feo Less AOP� Fee PaiE $ Balan[o0uo S Phone ZiP - Phone qttach four (4) copies ol plans for proposed work - Draw to scale and note � CQo1;eriine of stree1t a61e: • property Lir:es • Indicate North • Outllne and dimensions of all existing and � Show any proposed grading changes . proposed structures on the lot � Show measurements � Existing and proposed utilities PERMIT CONDITIONS 1. Ail cails tor inspeclion shall be made 24 hrs. in advance • phone 259-8810. 2. All work shall be performed in accordance with lhis permit 2nd currenl Ciry of Everett Design and Construction Stendards and Specifications. 3. Call Localion Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•S00•424•55. • �� V �;�`� j��ig � Approved tor Construction Date FINAL INSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett, WA 98201 Phona: 259•8810 FlCKNOWLEDGEMENT OF CONDITIONS � O � O a The undersigned owner/applicant hereby agrees to hold and save harm- less the Ci:y of Fverett Irom any and all claims lor damages, costs, expenses, or causes ol action that may arise because of installation and maintenance o( lhe improvement or other right•of•way use hereto applied lor and furiher agrees to remove same upon notice irom the City znd [o replace PuGlic property damaged thereby. Signature of Applicant Date VJORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PER�11T IS ISSUED AND THEREAFTER IS TO CANCELLED BY THE C TY UPONOANY .STOP AGEIOF WORK ON THIS PROJECT OVER 90 DAYS DURhTION.