312 SE EVERETT MALL WAY 2018-01-02 MF Import

r Date Application For PUBLIC `NARKS PERMIT Print or Type Only Describe Proposed Work Project Address (if known) Public Works Permet 6 r — 210 ce Bldg. Dept • / Public Works Fee $ Total Fee Leas Appl. Fee Paid Balance Due $ (-TZ- 21W 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 LIN PERMIT CONDITIONS . 1. All calls for `nspection shall be made 24 hrs. in advance - phone 259.881 5. 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. TOL L FREE NUMBER 1.800.424-5555. lewole. To BE' lb.✓E AL--e Ai;uoi2odEw 'De'WIf h.9T�o �o-29-z9> Approved for Cc uctlon Date 7 Approved as Constructedf,/ everett PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett, WA 98201 Phone: 259-8815 U) M O n Cl) CL ACKNOWLEDG _MENT OF CONDITIONS The undersigned owner/applicant hereby agrces 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-ol-way use hereto applied for and further agrees to removo same upon notice froal the City and to replace public property damaged thereby. t Signature of AhQlicint ' Date WORK AUTHOHIZEU BY THIS PERMIT MUST BE STARTED WITHIN 18o 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.