305 SE EVERETT MALL WAY JENNY CRAIG 2018-01-02 MF Import

Date �f - v" Application For PUBLIC WORKS PERMIT' Print or Type Only Applicant Address \ IPublic Works Permit x _ Bldg. Dept . Pobltc Works Fee $ Total Fee Less APPI Fee Paid S Balance Due $ r., 7- Dl......, City Zip Describe Proposed Work W Project Address (if known) Attach tour (4) copies of plans for proposed work - Draw to scale and note the following as applicable: t11� • 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 DO NOT WRITE BELOW THIS LINE PERMIT CONDITIONS O 1. All calls for inspection shall be made 24 hrs. in ad%ance- 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 his. before you dig. TOLL FREE NUMBER 1.800-424-5555. now O 77-i�-�a O a 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 or installation and maintenance of the improvement or other right-of-way use hereto applied for and further agrees to remove same upon nelice from the Approved for Construction Date City and to replace public property damaged thereby. FINAL INSPECTION Date Approved as Constructed Signature of Applicant Date ii PUBLIC WORKS DEPARTMENT WORK AUTHORIZED DY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO 3200 Cetlar Street BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE Everett, WA 98201 ICANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK Car THIS Phone:259-8810 PROJECT OVFR 90 DAYS DURATION.