2102 EL CAPITAN WAY 2016-01-01 MF Import

r--------- --••---,-. - .__. __�,_ A �,---- i Date I 8�-2/ 7 Publlc Works Permii• I Application For - emq.oapi.. I PUBLIC WORKS PERMIT PublicWo�ksFeo � . Tolal F�o � Loss Fpo�Fee PeiO S IPrint or Type Only ea�a��o o�a s ��— CAs<mo�r PRoPFd1-�r��+ ��hQr,�r��Sl4 i P 1 �yi� �e�c;Fa �`� 1.1 �"31b SPA'� ��1�L� � Owner tdailing Address City Zip phone I II / c, J��}1�1 � 5\)(Zy �� l N`t�l.II�C,E(L, /o n't14.�� .� I�l)ESI bt�A1 i � (�y�Jr /1 vtL2�c 9s i Applicant Mailing Address City Zip Phone �I ; ,;� �_'- F3.� -GG�/ i I Describe Proposed Work � � � � - -s � % ' -ti'/J 'G � ny li I iv ; i � � � I � � - �, — I Proje�t Address�it known) �J � I l TK .� � IAttach four(4)copies of plans for proposed work• Draw to scale and note the following as applicable: � � ', ' - • Property Lines • Centerline of street � r. � � • Outline and dimensions of all existing and • Indicate North i 4 I proposed structures on the bt • Show any proposed grading chan9es • Existing and proposed utilities • Show measurements � i 'i � � I DO NOT WRITE BELOW THIS LIVE �I � PERM�1'CONDITIONS O ' � i � 1. AII calls tor inspection shall be made 24 hrs in advance• phone 259•881 5. � � . All work shall be performed in accordance with this permit and cur.ent City of Everett Design and Construction �� � Standards and Specifications. � � 3. Call Location Underground Service 48 hrs.bebre you dig.TOLL FREE NUMBER 1•800•424•5555. � I , y � , , �'� r�/'i�Jc � � < '/ ; I I �� T', E.��'O�{`/O�� O /J TiPvL �(f' �J�C�C'/C�C..�/ d� � � i ��cCjO � � �' , � P,P.o,c 7.� .�� s�E.u,,,r li::�'ti� ; �- ,�/y�.P��ic ��C'�nir ��,��_� �"�� QA � G�i7JC �J��,9�jy�T '�f nr E�Far. ' �i �� A�r 7��3�/ i i � I � ACKNOY�4EDGEMENTOFCONDITIONS � The undersigned owner/applicant hereby agrees to hold and save harm• i less the Ciry of Everett from any and 2II claims for damages, costs, I j ��- � expenses, or causes of action that may arise because of installation �l ��j�7 and maintenance of the improvement or other right-of•way use n�reto � � �G,-�� applied (or and further agrees to remove same upon notice irorn the � ��i �ed fp/ ons ion Date City and to replace public property damaged thereby. I � _ ; ,9,9r= I � FINAL INSPECTION D2te _ I Approved as Constructed ig ture ol A plic te � O K AUTHORIZ Y THI PERMIT MUST BE STARTED WITHIN I I everett PUBI IC WORKS D[Pna7MENT w 1 3200 Cedar Stre�t 1 DAYS OF DAT[ PERMIT IS ISSUED AND THEREAFTER IS TO , �I Everett,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE � P�one:25s�a875 CANCELLED 8Y THE CITY UPON ANY STOPPAGE OF WORK ON THIS � PROJFCT OVER 90 DAYS DURATION.