20 SW EVERETT MALL WAY DANIELS HAIR DESIGN 2016-01-01 MF Import

Date `� L�.��'� Application For PUBLIC WORKS PERMIT Print or Type Only o ner � / Address � � P�DI¢ Wo�Fs Permlt � eieo oea�.. rrR �� ¢/ PubLc WoreS Fee $ TOIaI Foe LesS Appl Feo Paitl $ Ciry Zip Balance Due �a � '� Appiicant Mailing Address City Zip Phone Descri'oeProposedWork /flAnh��na�»✓L✓Npn /� 'In� /J�.�1P�S �Yai�� P.r� Proiect Address (if known) Atlach lour (4) copies of plans for proposed work • Drew to scale und note the following as applicable: • Properry Lines • Cenlerline ol street • Outline and dimensions of all existing and • Indica!e North . proposed structures on the lot • Show any proposed grading chaeges � Existin� and proposed utilities • Show measurements PERMITCONDITIONS 1. All calls for Inspeciion shall be made 24 hrs. in advance • phone 259•881 O. 2. All work shall be periormed in accordance with lhis permit and current City of Everett Desio� and Construction Standards and Specifications. 3. Call Locatior� Underground Szrvice 48 hrs. before you dig. TOLL FREE NUMBER S•800•424•5555. �/D � 2�"Q Approved for Con;truction Dale FINAL INSPEC710N Approved as C .structed everett 'rUBLIC WORKS DEPARTMENT � 3200 Cednr Sireet Everett, WA 98201 Phone: 259-8870 FlCKNOWLEDGEMENT OF CONDITIOiJS W H � � � � � � � The und2re.igned owner/applicant hereby agrres �o hold and save harm- less the City of Everett Irom any and all claims lor damages, costs, expenses, or cause� ol action that may arise bec��use of installatlon and maintenance of �he im.�rovement or other righho4way use hereto applied for and further agrees to remove same upon notice irom the City and lo replace pub!ic property damaged thereby. Signature ol Applicanl Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND 7HEREAFTES IS TO BE DILIGENTLI' PURSUED TO COMPLETION. THIS PERI.lIT MAY E!E CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.