909 SE EVERETT MALL WAY WA CREDIT UNION 2018-01-01 MF Import

Da�e�`'��% Application For PUBLIC WORKS PERMIT Print or Type Only QWfICf Applicant Oescri�e Prcposed Work Project Address (if known) Mailing Atldress II 'T I /�l�� nm:i c..m ^e — `—J / — aueiic Works Fee Tolal Fee S Less A00� Feo Paitl u ealanco Duo $ A��ach lour (4) copiFs of p!ans for proposed work - Draw to scale and note Ihe lollowing as applicable: • Properiy Lines • Centerline of sireet • Oulline and dimensions of all existing and • Indicate North proposed st�uctures on ihe bt • Sho:v any proposed gradinq changr,s • Exis�ing and proposed utilities • Show measuremenis PERMIT CONDITIONS G. �• , Phone 1. All calls (or inspection shall be made 24 hrs. in advance - phone 259-881 5. 2. All work shall be performed in accordance with this permit and r,urrent City of Everett Desiyn and Construction Standards and Specificalions. 3. Call Location Underground Ssrvice 48 hrs. hefore you dig. TOLL FREE NUMBER 1-800•4�24•$555. /�Uf�'!/C Lc�O/<'.�'S /-F/'/�/� /(�'i'T �G=�Cii,�:F.O /�� b''7 Approved for Cans�rudion FINAL INSPECTION Date Approved as Consiructed cverett PUBLIC WORKS DEPARTMENT � 3200 Cedar Sireet Everett, WA 98201 Phone:259-8815 f / �.'-� f��//I ✓ !/ ACKNOWLEDGEMENT OFCONDITIONS W � _ / � � The undersiqned a�.vner/applicant hereby agrees to hold and savc harm� ie,s (he City of Everett from any and all claims lor damages, costs, expenses, or causes of action that may arise because of installation and maintenance of ihe impwvement or olher right-of-w2y use hereto appiicd ior and further agrees to remove same upon notice from the City and to replace pu6lic properry dama�ed thereby. Ufc of AppliCant Date WOFiK AUTHORIZED BY THIS PERMIT MUST 8E STARTED WITHIN iB0 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 STUPPAG[ OF WORI<ON THIS PROJECT OVER 90 DAYS DURATION.