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PI�BLIC WORKS PERMIT Date: 1/19/2012 <br /> " , - , ,,�, PublicWorksPermit#: PW1201-005 <br /> Ciry of Everett Pu li Works Depreuti�heh4 ;, , ,�-, guildinp Permit#; K1201-005 <br /> 3200 C��r Street , 7 <br /> Everett, W�4 8201, . `Planning Reference#: <br /> (425) 2�7��810 '''' <br /> Public Works Fee$: $ 45.00 <br /> � '`,� Other $: <br /> �'�;�� <br /> OWNER NAME AND ADDRESS: ti APPLjC14NTi NAME AiVD ADDRESS: <br /> � ��' "'�' EMERALD FIRE LLC <br /> EMERALD FIRE LLC � ,.;� ���y <br /> 11021 CRAMER RD KPN T� 7`�1Q21'CRAMER RD KPN <br /> GIG HARB R WA 98329 <br /> GIGHARBOR WA 983z9 i:u?i� . P <br /> PHONE: 2538572056 PHONE: 2538572056 <br /> TAX PARCEL ID# 28042400200100 SITE ADDRESS: 10011 EVERGREEN WAY <br /> DESCRIPTION OF PROPOSED WORK: <br /> DOUBLE CHECK DETECTOR VALVE-HOBBY LOBBY <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection shall be made 24 hours in advance. <br /> 2. All work shall be performed in accordance with the permit and curcent Ciry of Everett Design and Construction Standards <br /> and Specifications. <br /> 3. Call Location Urderground Service 48 hrs before you dig. TOLL FREE NUMBER 811 <br /> 4. DCDA in vault outside building per City Standard#515 <br /> CONTACT RANDY ALLEN AT 425-339-7403 FOR QUESTIONS AND INSPECTIONS � <br /> ►.n <br /> � <br /> 0 <br /> h <br /> 0 <br /> � <br /> � <br /> L� <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and <br /> save harmless the City of Everett from any and all claims for <br /> damages, wsts,expenses,or causes of aclion that may arise <br /> /J /' because ot installation and maintenance of the improvement <br /> � ///� �•Zy �/Z or other right-of-way use hereto applied for and further agrees <br /> �-,�� to remove same upon notice from the City and to replace <br /> Approved for Construction Date public property damaged thereby. <br /> FINAL INSPECTION Date ^'�L' ' /2 <br /> Approved as Constructed Signature o licant Date <br /> WORK AUTHORIZED BY TH[S PERMCf MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY <br /> PURSUED TO COMPLEIION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY S70PPAGE OF WORK ON THIS PROJECT OVER 90 DAVS DURAl70P1 <br />