4605 COLLEGE AVE 2018-01-02 MF Import

Date7-s/ -9 Public Works Permit# C/ 6 - 2/ 7 Application For Bldg.Dept.# PUBLIC WORKS PERMIT Public Works Fee Total Fee $ Less Appi.Fee Paid $ Print • or Type Only Balance Due $ 4D Cf/ffeo.e • MK-1111J L./fl.Jeaxvne-Sit1moios -51605 ea/i L ete 1 !,cash- .2-03 i-6SV/ Owner Mailing Address City Zip Phone Applicant Mailing Address City Zip Phone Describe Proposed Work us.e_ LA h open ex), o!.I (e cf rmw -Ft)v US as I.a.u,+ti. 4.4,8e.14- ( . / W Project Address(if known) 4405 1.,0 t ie Attach four(4) copies of plans for proposed work- Draw to scale and note the following as applicable: mmin • Property Lines • Centerline of street • Outline and dimensions of all existing and • Indicate North CO proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements CO• DO NOT WRITE BELOW THIS LINE PERMIT CONDITIONS O • 1. All calls for inspection shall be made 24 hrs. in advance- phone 259-8815. 2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig.TOLL FREE NUMBER 1-800-424-5555. am y&'=-4sfi r zjA irnP,2 V6.v ACCe-/ O illIllIll (t9&i1'4 8,4xpeW S,pycE> t, imalip I- vCin um 4 g 0 a'/ 4l0` PErznneg�e tZ7 S%ee eTU,ees ,9,eg To 476 Plac Z. ' d" �-� 6: 77/6" G iT s s 7HE ,e/6--4/ T U7Gi2E Tom- %G ee7 �T .�/ 1m ACKNOWLEDGEMENT OF CONDITIONS 5" The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett from any and all claims for damages, costs, expenses, or causes of action that may arise because of installation 7 86 and maintenance of the improvement or other right-of-way use hereto Approved for Constru io Date applied for and further agrees to remove sarne upon notice from the City and to replace public property damaged thereby. .,...- -------------- a . , FINAL INSPECTION Date ' - 41--"--144-4.14'7 7 /-aN Approved as Constructedig atur f Applicant Date everett PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 3200 Cedar Street 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO Everett,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE Phone: 259 8815 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.