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) � <br /> PUBLIC WORKS � Dd1e '�;�1':°°` <br /> PublicNlorksPermit8 pWG6J3-037 <br /> PERMITBuildingPermit# _OE03-085 <br /> PUBLIC WORKS DEPARTMENT Plannin9 Reference N <br /> 3200 Cedar Slreet Public Works Fee$ <br /> 'd 1:;: .�� <br /> Everelt,WA 98201 = � <br /> (425)257��,�OSTIN� APR 15 Z�� Gaarantee$ '� <br /> � a...................... <br /> OWNER NAME APPLICANT NAME <br /> AND A�DRESS:EVEF.C+P.EE77 F'�TAIL LL'� AND A�DRESS: FB'i h1iiF.^: <br /> 1_15 SENF:CA S; �100 <br /> SE?�TTLE Uh 9Slii': <br /> PHONE: 51i"pl� ' 1 <br /> PHONE: ?i�b38=1=2f abuGl <br /> PROJECTADDAESS: <br /> TAX Pl.RCEL I.D.# - ; F•,rL- _-: � r' � <br /> 00_Ofi91��195pi;? <br /> DESCRIPTIONOF �^I�D�Sj[,n:-T=;"��7F :;T.I rF,.�n.: `F?rz' <br /> PROPOSED WORK: <br /> :C.j ,^ ESP k[�?-�l�lri <br /> PERMIT CONDIT�ONS <br /> 1. All calls(or inspection shall be made 24 hours in advance-�F+e�« ; "�� �` <br /> � oa,� <br /> 2. All work shall be pertormed in accordance with this permit and current City of Everett Design and Consiruction <br /> Standards and Specifications. � ' <br /> 3. Call Lucation Underground Service 48 hrs.before you dig. TOLL FREE NUMBER 1-B00-424-5555 <br /> r <br /> : ✓_' S i� r r ' �iT' �' T}� T"_-, _ 1�� <br /> i '� Lk :�_kPi iVEL FLh11 ?. +L� i n�Y T,!c:5 r;EC?i�', � FIEiG. , /A <br /> > >l�F. ST7SFECT•GF FOF. THIS F47 FEF'11IT IS: r,..i��r . � V/�/ <br /> _?FF �:}�ci�n.�;. ti.:` � _ . - v�,iy �_. - _, . - W <br /> - � —1 Ti—�T��tJl�� <br /> -�f G�ufn �: O <br /> '^a:'n - <br /> � "c�� <br /> _ �i�l �� � <br /> r-, _ <br /> O <br /> f- ry .. <br /> � �' � <br /> v+ � <br /> �.�lr�c*1bw i� <br /> i. , _- � <br /> 'i`, , O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> ��i� � � ' The undersignad owneUapplicant hereby agrees ro hold and <br /> � save harmless ihe City of Evere!t from any and all claims tor <br /> �a damages,costs.expenses.or causes of action that may arise <br /> qp . -;for Con, n becau=_e of in;tallatinn and maintenance ot!he improvement or <br /> other rigM-of-way use herelo applied tor and further agrees to <br /> � � �'�=``�/'_ remove same upon notice trom the City and to replace public <br /> i proper Q�ag therehy. <br /> �INSPEGTION' (/ _ _�� <br /> Appmved as Consimcted Date �, , _ <br /> �; �•+ f__ ��,; � Si naWreoiAp icant Date <br /> O COMPLEOON 7�H S PERI�IT PdA I BE CANCELLED 81'�THE CITY�UPON ANOY S�TOPPAGF OF WORK ON THIS PflUJECT OVER 9 DAYS D RAN ONPURSUED <br />