406 SE EVERETT MALL WAY BASE FILE 2018-01-02 MF Import

I 1 Application For PUBLIC WORKS PERMIT Print or Type Only Address Describe Proposed Work Protect Address (if known) ,g City Zip Public Works Permgs7it w - Bldg, Dept. a �y� -- Public Works Fee $ Total Fee Less AFee Paid r balance. D Duo $ Attach four (4) copi,:s of plans for proposed work - Draw to scale and note the following as applicable: • Propurty 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 Militias • Show measurements PERMIT CONDITIONS 1. All calls for inspection 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. TOLL FREE NUMBER 1.800.424.5555. S- __& &liG z"6 '?�' z7G Approved, 'onstruction ,� Date FINAL INSPECTION Date Approved as Constructed ereren PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett, WA 98201 Phone: 259-8815 CA 0 a ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant herebyagrees 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. W Signature of Applicant WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS Tr BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY r CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON T PROJECT OVER 90 DAYS DURATION.