3611 FEDERAL AVE 2018-01-02 MF Import

Application For Date >> PUBLIC WORKS PERMIT PUBLIC WORKS DEPARTMENT Public Works Permit # 3200 Cedar Street Everett, WA 98201 259-8810 Building Permit # O TYPE OR PRINT ONLY Public Works Fee $ Oc (1 (a.r 4 %wt Owner Mailing Address City Zip Phone M Applicant ailinAddress City AddCity Zip Phone Describe Proposed Work L I �Z `t��'' �'Ge Q��P"�� W O rCr Cyr/U G 'R ..J PROJECT ADDRESS (if known) 164 Attach four (4) copies of plans for proposed work - Draw to scale and note the following if applicable: (-+'�' �-''t 0 •Property Lines •Outline and dimensions of all existing and proposed structures on the lot "Existing and proposed.6ti60 "'Centerline of street 'Indicate North •Show any proposed grading changes 'Show measurements PERMIT CONDITIONS: 1. All calls for inspection shall be made 24 hours 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 Specificatio.is. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. y Approved for nstruction uare FINAL INSPECTION Approved as Constructed ,,7 z O 7.5C ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harmless the City of Everett from any and all claims for damages, costs, expenses, or causes of action that may arise because of installation and maintenance of the improvement or other right-of-way use hereto applied for and further agrees to remove same upon nctice from the City and to replace public property damaged thereby_ WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE -PERMIT COMPLETION. THIS PERMIT MA. BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF -WC of Applicant-- fiSSIfED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO Ik'16N THIS PROJECT OVER 90 DAYS DURATION.