906 SE EVERETT MALL WAY BLDG C KELLY SERVICES 2018-01-01 MF Import

oate111��sg C Application For PUBLIC WORKS PERM1�' Print or Type Only �, Pu�lic Works Permll a eiee- oeo�� + — Pubi¢ WorFs Fee s Total Fen Less AppL Fee Paid 5 Balance Uue S 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 ihe follcwing as • Property Lines • Outline and dimensions of all existing and proposed sVuctures on the lot • Existing and proposed utilities • Centerline ot slreet • Indicate North • Show any proposed grading changes • Show measurements PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hrs. in advance • phone 259•8&10. 2. All work shall be peAormed in accordance with this permit and current City of Everzt! pesic�n and Consiruction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-500•424•5555. Approved for Construc!ion !�'/`,-�- ��''C-},_��(�1� � ?� //-/�� ACKNOWLEDGEMENT OF CONDITIONS W H � � � ♦rA V♦ 0 a The undersic�ned owner/applicant hereby agrees to hold and saee harm- less the Ciry of Everett Irom any and all claims for damages, cosls, expenses, or causes ot action that may arise because of installation 2nd maintenance of lhe improvement or other right�of�way use hereto applied fer and luriher agrees lo remove same upon nolice irom �he Date City and to replace pu6lic pr�perty damaged thereby. FINAL INSPECT�ON Date ApProved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 CeCer Street Everett, WA 98201 Phone:259-8810 Signature ot Applicant Date �VORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 130 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS 70 BE DILIGENTLV PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.