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<br />PERM�T � r,o�
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<br />PUBLICWORKS�DEPAR ENi,^t�_:r.�
<br />3200C�d�'rSifeet�� " " ``-�� -
<br />Everett, WA 98201
<br />(425)25�-8810_�, 'ij�4`1�'.1�
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<br />OWNER NAIdE
<br />ANDADDRESS: ;.p,.r�rr._.:I� �'j .� -,.::i�
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<br />PHONE: :_ i i �: :i 17 ° 5 i
<br />TAX PARCEL I.O.N
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<br />�ESCRIPTION OF
<br />PROPOSED WORK: ''�`? �! .` .' . _ -
<br />PERMIT CONDITIONS
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<br />Date
<br />Public Works Perm;t # L'=� t0 t v3?
<br />Budoing Permit k
<br />Planning Reference #
<br />Public Works Fee S
<br />Guarantee 5
<br />T� POSTING FE°.o,u Zao�
<br />1. All calls for inspection shall be made 24 hours in advance.
<br />2. All work shall be per(ormed in accordance with ihis permil and current Ciry o( Everett Design and Construction
<br />Standards and Specificalions.
<br />3. Call Localion Underground Service 48 hrs. be(ore you dig. TOLL FREE NUMBER 1-800-424-5555
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<br />. s�:.cinkl�r �y:te;a is n=quie�;i fc,c thic t}uildinq in �:n:n�;iian�.e with ii,_. ,_.-..
<br />-uicemrnts of TlFDA St�m:larrls 13D
<br />�?1" ��ict, tnud, e��r_t:� ue ���bcis rn }.a :_•.q�_tgd �,nto L03��13�f
<br />. 17�� con�tzucticn mat=Lia1�, :•ehjcles, dump�t=rs, �t�^. t•_� b� p:ace.i ._. . i_�� __ _
<br />.�dway. nn;��way r_n l,e acc�;��r:ahl? to einee�aency vFhlrle� dt a.11 tiroe.,.
<br />�. r..-.r�.nr���➢{.P�.j 11.`tifli� ii [�'4. CC'O`33 'SZr�FiE �OC Tir•4: COFIC�wg�
<br />_ . ;:Ff7GV� j?13(1��L' i31an�3 �?39t :�2�� 02 C�C1V9 pr.j;,n;�irr� rj1�1Cr11. T���^.OVE� _.... _', _." ' ,
<br />.i t.r�z'ti ntructuc�l iili
<br />. Exi;>tinq luminAice t.n be re:�crved anci cQectrical cix_r.��it t�f an r�pF�aer.,:�=ii �. �
<br />ur.r.nr_�c,,r.
<br />__... �'iOj)G9E'�j L"03�D3y t.0 �OI�:�N SC3R�3i,:I �f_(1^-, Yn1' .�'.L!'UCtU-3� •=:'15LL.L`CCiO❑
<br />. Znatallation ef a fire itvdC3llt 3L Ni3CI130❑ i� r��7uic._.i f�_e rhe a�ns*�acr:;:.
<br />. WoiY. c�n ulieyti+ay shail b� ciane per letter � - .
<br />o�tru��tion will lae a�iju9ted in field as nr��
<br />_uctu��a1 �^onstruction.
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<br />Appmved lor Consimclion ato
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<br />.';FINAL INSPECTION
<br />Approvod as Constmctetl �alc
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<br />P10RI( AUTHORI�eD OV THIS PERMIT MUST 9E STARTED WITHIN 7B0 DAVS OF DATE PERMIT
<br />TO COMPLETION.7HIS PERMIT MAY BE CANCF.LLED �Y THE CITY UPON ANY STOPPAGE OF
<br />rP�vr �z�oci
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<br />ACKNO`NLEDGEMENT OF CONDITIONS
<br />The undersigned ownerlapplicant hereby agrees to hold and
<br />save harmless the City ol Everetf Irom any and all claims for
<br />damages, costs, expenses, or causes o� ac�ion Ihal may arise
<br />because ol installation and maintenance of the improvement or
<br />other right-o6way uso hereto applied lor and funher agrees to
<br />remove s�rne upon notice Irom the City and to replace pu6lic
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