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� <br /> y <br /> Date �/7/::UO�� <br /> PUBLIC WORK� publicWorksPermittPWO'05-OOfi � r <br /> PE R M 1 T Bcilding Permi�tt <br /> PUBLIC WORKS DEPARTMENT P�anning Relerence a <br /> 3200 Cedar Streel � <br /> Everett,WA 98207 <br /> Public Works Fee S ^"'� ' �� <br /> (425)257-8810 Guarantee S <br /> OWNER NAME, APPLICANT NAME <br /> ANDADDRE58�at��-h �-1�E'YS ANDADDRESS: <br /> PU ROX h0095 Q� <br /> SEATiLE W7+ ��;16� �� <br /> PHONE: PHONE: <br /> 425304786`5 <br /> 7AXPARCELLD.tt PROJECTADDRESS;,���.� L�JfR}�ICCl AV�:T11Ae <br /> DESCRIPiIONQF �Z.I V�2Wc� <br /> PfiOFOSED WORI� Y <br /> pw <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection shall be made 24 hours in advance- phone (425) 257-8810 <br /> 2. All work shall be performed in accordance with this permit and current Ciry of Everett Design and Construction <br /> Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. be(ore you dig. TOLL FREE NUMBER 1-800-424-5555 � <br /> ' . r�:c 1��i .:�pptova�l li' .�n duteci 5/7� i�� . � <br /> � . Iiistall ti�w di iv� way aprn,� � p i cit:y ot rver� tL. �tatidnrd T'� ai� � <br /> ;{ ipb V/ <br /> v . C:,i11 +?9 l403 tu aerang�a � m� r t.in�7 with th_ p�il,lic wock.:; inspector <br /> prioi 1:.o Leqinnirig work . � <br /> �, �Z�� -�a+� -I�h,_ I�icic e�g� o� -�k� s�de�IK 20 ' t�t��� O <br /> � ow�r� �-I'h� h,ov5� =�o l�I p p��-1' � o�I -�� +��k;� O <br /> o�l-Iro -}'�- s��eu1ivtf� u o�osoos <br /> ' DRIVE 2s.00 <br /> TOiA_ �5.OU � <br /> CF-uEK �� <br /> A OM7823 O <br /> a <br /> � y_ o �� <br /> �,�� ���-_��,,��. ;r��� <br /> Nvr {��tu�.F> i;� <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> c, n � � O� The undersigned owner/applicant hereby agrees to hold and <br /> _�y/ save harmless the City of Everett irom any and all claims lor <br /> n� roved ior Cons�mc�ion aie damages,cosis,expenses,or causes ol aclion ttiat may arise <br /> beca�se of installation and maintenance of the improvement or <br /> other right�ol-w hereto applied for and lurther agrees to <br /> rem�e sam upon n tice Irom the Ciry and to replace public <br /> FINAL INSPECTION pr, erty aged t ereb . <br /> Approved as Consimned Daie � ? a � <br /> ignaWre of App icant �e <br /> l"JORK AUTHORIZED BY THIS PEFMIT MUST BE STARTED WITHIN 1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED <br /> i0 COMPLETION.THIS PERMIT MA1'BE CANCELLE�BY THE CIN U?ON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />