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( <br /> PUBLIC WORKS °a1e ' -` � °„ '� <br /> Public Works Permit� :- .- . . -�,'_', <br /> PE R M 1 T Building Permit x <br /> PUBLIC WORKS DEPARTMENT Planning Reference u <br /> 3200 Cedar Street �_., �, �: ;, <br /> Everel4 WA,� � -- p�:�� N '� �7 Public Works Fee S : - - Q <br /> ,4z5�25�-a�`�;'b9S � ING..... `J __: ;:�-g <br /> ���������� Guarantee S <br /> OWNER NAME APPLICANT NAME <br /> ANDADDRESS�. ;��•y�p,Q^Fxi Gr��.'Es,�.�c1ar1;'_ ANDADDRESS�. Fp�''::•1tIiE'.� fi:'N`i11LT�'i= L:A:T;IFs'�. <br /> lE'16 i:.;i_ .�,':i _ . . .._ :"ci:� 1:1iL AVE SGIfTH <br /> }CEN'T Fi. r:(:}_ h^;'.iT wA �Si'_:: <br /> PHONE: PHONE �r7r.� <br /> q?5?Sl�illi� 4..+_. if,;2:: <br /> iA%PARCELI.D.a PROJECTADDRESS: <br /> ' � � Fr'=W.1S' �L <br /> JFSCRIPTION OF <br /> PROPOSEDWORK: SIL�'�F. L� FSD6E COHpC�h±ItiIlmiS <br /> Th�';:4'= .'�f1-.."'?5'. :I'�-.._. .'.�rr,S gi..._ . <br /> PERMIT CONDITIONS <br /> '. All calls for inspectior� shall be made 24 hours in advance - phone (•125) 257�8P70 <br /> 2. All work shal'be performed in accordance with this permit and current Ciry of E�eretl Design and Construction <br /> Standards and Specifications. <br /> 3. Call Loca�ion Underground Service 48 hrs.be(ore you dic�. TOLL FREE NUMBER 1-800•424-5555 <br /> W <br /> . _ �.-. ..__:�= _-. : _... -_. I— <br /> — <br /> � <br /> m <br /> O <br /> � <br /> Z <br /> O <br /> H <br /> � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> � � � l j Tho undersigned ownerapplicant hereby agrees to hold and <br /> .:����,��-�;�, save harmless the City of Everett Irom any and all claims lor <br /> nop�o�:ed ro�Consimaion Da�e damages,costs.ezpenses,or causes ol action that may anse <br /> because of installation and maintenance ot the impmvement or <br /> cther right�obway use herelo applied for and lurther agrees to <br /> ��.���� _ - remove same upon notice Irom Ihe Ciry and ro replace pubiic <br /> I SPEC ION � pro ty damaged ihereby. <br /> Approved as ConslruUetl Dale ' � �� � <br /> 3 — z/ _ �� SgnaWre ol Appli� ale —' <br /> P;OPK AUTHORIZED B�THIS PFR1.117 t.7U5T�E STnRiED 171THIN 180 DAVS OF DATL PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLv PURSUED <br /> i����'.��'.��'I.EiICtJ THIS PF-�t.11T tdAY�E CANC[LLED BV 1HF CI7Y UPOH ANY STOPPACE OF WORK OtJ THIS PqOJECT OVER 90 DAVS DURATION <br />