1402 SE EVERETT MALL WAY LADY FOOT LOCKER 2018-01-02 MF Import

H N K � � O N O rd H rC N H to H O H N n o H te0 0 • CTn 7 H H O 0 H N O H n o N Date_4_4j2f�fl l r r Application For PUBLIC WORKS PERMIT Print or Type Only Owner ulty Puhlic wall" Per.((..�.. "� Bldg. pool. a —Lf Public Wor" Fee Total Fee Less spot Fee Paid S Balance Due $ 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 applicable: • Property Lines • Centerline of street • Outline and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements PERMIT CONDITIONS 1. All calls for Inspection shall be made 24 hrs. In advance - phone 259.8810. 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. NO PftbIIL 14/0-fL Arm;7 gay f41^J1 Approved for Construction Date FINAL INSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT Ever tt WA Street Everett, WA 98201 Phone: 259-8810 e CD 01 a O am ACKNOWLEDGEMENT OF CONDITIONS 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 properly 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 90 DAYS DURATION.