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f~$ <br /> ��. . .. ���'J� <br /> PUBLIC WOR�S °`�'° „ <br /> :wosr �-oo� <br /> PublicWorksPermi�# �p5(�q—p(i�j <br /> PE R M i T Building Permit# <br /> PUBLIC WORKS DEPARTMENT Plannini� Reierence# <br /> 3200 Cedar Street $25.00 <br /> Evereit,WA 98201 i °ublic�Jo�ks Fee 5 <br /> (425)£57-8810 <br /> r�r � � n Guaranieo S <br /> a� g���+���f�, i.Jd 1 J 2OOi <br /> �z''>�Ff"r=?::-:,—Z�': ��--..9 <br /> OVJNER NAIdE� J�� APPLICANT NA�dE <br /> P.NDADDRF.SS�U FO}: ZO$_t ANDADORESS: <br /> EVERET'[` 4Th °c�:"_;: <br /> 9255310176 <br /> PHONE: PHOIaC�. <br /> TAXPARGE�I.D.k � . `. . PFOJ[CTADDRFSS:� ".. '...•._..... ..... „ . <br /> }(EGI $Oif&F ' F,S,GT�' 1F.i, _1 <br /> DESCPIPTION OF <br /> PROPOSED NlOHK'. <br /> PERIv11TCONDITIONS �._��TT cIkS'" kI- '; <br /> t. All calls for inspection shall be r,iade 24 hours in advance -phone (425) 257-8610 <br /> 2. All work shall be performed in accordance with this permit and current Cily of Evere�t Design and Construct�on <br /> Standards and Specifications. <br /> 3. Call Location Underground Service 48 his.before you dig. TOLL FREE NUMBER 1•800-424-5y55 <br /> �l. :cnn�rr �lde sewee per Ci.y St:gnd3Cd #'s Fi01, 602, c;ii4. � <br /> �. 'Ii;e _�ontcactor rust meet w�ith the Fubli._ Wo[ks Insp?._�ro:: 2c �:ii:;�=u�cs �,�..�:er.��.l � <br /> -� iil�i�7� LCU*:111�1 i:L1PC ti �;.-;7�lllli�l�T =�1 � L��_ r f'1-3111i � i� �. C� !�ftUfi bJlll ❑E@�j '. . � _ v <br /> c i_..,i *_ , ti �i. .::k �i ,:❑ c� ., .__.r._,.I� .- _,., . _.�_ �nt_csecti�n. G'� <br /> ;,, ' _��-; W <br /> ` . ��:� - ,-�_ ,-' O <br /> `T <br /> � <br /> Z <br /> O <br /> iH 63 <br /> � . . '. . . . � � �r^ <br /> c eR <br /> �, _ <br /> V/ <br /> O <br /> a <br /> ACKN0INLEDGEtvtENT OF CONDITIONS <br /> The undersigned owneUapplicant hereby agrees to hold and <br /> ��, �7Y� �c. %/)/7�/ 6 5 save harmless the City of Everett from any and all claims for <br /> nopr r Consimc�ion oa�e damagea, costs,expenses,or causes of action that may anse <br /> ///::: , because of installation and maintenance ol the improvement or <br /> � /�/� / - �� olher ri�hboFwa e hereto applied for and lurther agrees to <br /> / /� ��"Z a remove sam i notice from ihe City and to replace pu6lic <br /> ` FINAL INS CTION propei�thereby. <br /> Mpmvrd as Cons�rucled Uate <br /> �_�— /U- //-US_ _- <br /> � SignaWro ol Fpplieam Date <br /> VJOfiK nUTHOR2ED�l'THIS P[R�d1T MUST E�F STARi[G 1711HIN I�0 DMS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGEN7LV PUHSUED <br /> i0 COGfI°I.f'_7101J.THIS PERI.1l7 F.+.AV GE CANCCLL[D�V TH[CffY UPON NJY STOPPAGE OF WOqK ON THIS PROJECT OVER 90 DAYS DURATION. <br />