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/ <br /> PUBLIC WORKS Date �jl��:�i ��^ <br /> PublicWorksPermitu FWOri05—i�15 <br /> PE R M 1 T Building Permi�p <br /> PIIBLIC WORKS DEPARTMENT Planning Reterence# <br /> 3200 Cedar Street public Works Fee 5 c�:,!lp <br /> Everett.WA 98207 <br /> �a25)257-B810 Guaramee S /2'/ <br /> /� ` <br /> CVJNER NAtdE APPLICANT NAME <br /> ANDADDRESS hIFIFT� �'F-�F.D F i;ILLi ANOADDRESS-. <br /> ib �LEri�;;;� ;:�� <br /> EVF:FiETT �"'• <br /> PNONE. <br /> PHONE� q�5j5ia7hn <br /> TARPARCELI.D.a PROJECTADOI7ESS: 1��, �L�l,��i'-'�' a,.'� <br /> 003a,pppi�ii3�1_ <br /> uEorosEowoFK. 1��'VE 7'FEE' AR"1?HD Tf� Hc:�i1'iE <br /> PERMIT CONDITIONS <br /> 1. All calls lor insper.tion sliall be made 24 hours in advance- phone (425)257-8810 <br /> 2. All work shall be performed in accordance wiUi ihis permit and current City of Everett Design and Construction <br /> Standards and Speci(ications. <br /> 3. Call Location Underground Service 48 hrs.belore you dig. TOLL FREE NUMBER 1-800-424-5555 � <br /> :. All 4r_d h��ucs uf work fir�m �.�e;cdays is � :� ii�Eh:. �' <br /> P�ovide ereaien r.onteol if the naed a�ia�:� and a:_ i: _ , i, _� r � -;i_ ��/� <br /> �� 'C� '� V/ <br /> ?n:.� ._. .�. r , r;nl�� nll%_n i9:�-,3u_7$i�:�) . r, H _ ": <br /> . ~ W <br /> C7 r�- � z <br /> � � O <br /> c\ �T. <br /> = O <br /> G �;,:-; � <br /> N r'•I ' Z <br /> Cn c , � <br /> ff3 =. <br /> r� -� <br /> ..,�n =' F— <br /> �o� �. � <br /> _� �o� '-. <br /> �-��]Ll O <br /> ��. ` <br /> : ._.,.:, a <br /> ACKNOWLEDGEMENT OF CONDITiONS <br /> The undersigned ownerrapplicant hereby agrees to hold and <br /> � /�/_��� S�C� O _ save harmless Ihe City ol Everett from any and all claims br <br /> i• damages.cosis.erpenses,or causes of action iha�may arise <br /> A, .�ved� nslmdion ��� <br /> � because ot installalion and maintanance ol the impmvement or <br /> �/�� / 7�^I Z olher nghl�o4way use hereto applied lor and lurther agrees to <br /> / � � (�{ . T" remove samo upon notice Irom Ih�City and to replace public <br /> %FINAL INSPE ON propei damaged Ihereby. <br /> ' � �- <br /> Approved as Cons�mcted �»t � _ � /, ����� �__��_�•�= <br /> 3�'� (i.;i.•fC <br /> ' SiqnaNre�Applieant Dale <br /> TO t�KI1ULLTOIOtJ il�i�vlT_(91.1�EIRAY C�E CANCELL[U l3Y'D HLTCITV�UPON ANOV S1�OPP.1GpOIF lIVO(1K ON THN9 PRORECT O E R 90 DAV3 D�(7AN ON rURSUED <br />