225 SW EVERETT MALL WAY 2018-01-02 MF Import

6/2$/9 13 258 Date ?*� Public Works Permit[}Jk077 Application For Bldg.Dept.# r't PUBLIC WORKS PERMIT Publico Works Fee Fee $ Less Appl.Fee Paid $ Balance Due $ 2o pUr Print or Type Only 8 a 8 8 8 Lcz O 04 Jump Start Expresso Bar 225 slr:::Eviigett Ma ,. Wy Everett 794-9497 Owner Mailing Address a- y-: 0 X :gity Zip Phone 35 as at w Applicant Mailing Address City Zip Phone Describe Proposed Work Place expresso stand W Project Address(if known) 225 Everett Mall Wy Attach four(4) copies of plans for proposed work- Draw to scale and note the following as applicable: nom • Property Lines • Centerline of street • Outline and dimensions of all existing and • Indicate North (In proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements DO NOT WRITE BELOW THIS LINE PERMIT CONDITIONS 0 1.All calls for inspection shall be made 24 hrs.in advance-phone 259-8810. 2.All work shall be performed in accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800-424-5555. z 0 (In a ACKNOWLEDGEMENT OF CONDITIONS 04' Fe G T The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett from any and all claims for damages, costs, expenses, or causes of action that may arise because of installation ‘81131.12.., /9(ya and maintenance of the improvement or other right-of-way use hereto applied for and further agrees to remove same upon notice from the Approved for Con ruction Date City and to replace public p5p damaged thereby. -93 FINAL INSPECTION Date Approved.as Constructed Si ur Applicant Date PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS •TO 3200 Cedar Street BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE Everett,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS Phone:259-8810 PROJECT OVER 90 DAYS DURATION.