1402 SE EVERETT MALL WAY LECHTERS INC 2018-01-02 MF Import

1` Date1LL u ' Application For PUBLIC WORKS PERMIT Print or Type Only Owner PrMailing Address City Zip Public Works Perm ll Bldg. Dept Public Works Fee $ Total Fee Less April Fee Paid $ Balance Due $ Phone Applicant Mailing Address City Zip Phone Describe Proposed Work _ Project Address (if known) t "(,-(,�rJ+ t —�� c—c��c--� c -r 1-a-L-�--LdL Attach four (4) copies of plans for proposed work - Draw to scale and note the following aas_apptica le• • Property Lines • Genterline of street • Outline and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed grading changes • Exiating and proposed uti!ities • 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 Spacifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800.424-5555. Approved to- Construction FINAL INSPECTION Approved as Constructed everett PUBLIC WORKS DEPARTMENT 3200 Cedar Street vEverett, WA 98201 Phone: 259.8810 Date Date ACKNOWLEDGEMENT OF CONDITIONS -ff No Y / M The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett from sny 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 90 DAYS DURATION.