1402 SE EVERETT MALL WAY IVARS FISH N CHIPS 2018-01-02 MF Import

Dete_�ELIS-7 i Application For PUBLIC WORKS PERMIT Print or Type Only Zip Public works Pamir s eiep.Dapt a Public Woks Fee $ Total Fee Less Appl. Fee Paid $ Balance Due S Applicant Mailing Address City Zip Phone Describe Proposed Work Project Address (if known) Attach four (4) copies of plans for proposed work - Draw to scale and note the following as • Property Lines • Outline and dimensions of all existing and proposed structures on the lot • Existing and proposed utilities • Centerline of street • Indicate North • Show any proposed grading changes • Show measurements PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hr: in advance - phone 259.881 5. 2. All work shall be periormed 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 -800.42e-5555. Approved for Construction Date FINAL INSPECTION Approved as Constructed i PUBLIC WORKS DEPARTMENT Everett, Cedar Street Ever8201 Eett, WA 98201 Phore: 259.8815 ACKNOWLEDGEMENT OF CONDITIONS Im z O 00 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 and maintenance of the improvement or other right-of-way use hereto applied for and further agrees to remove same upon notice from the City and to replace public property damaged thereby. Signature of Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER �)0 DAYS DURATION.