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I Date <br /> PUBLIC IAIORKS PublicWorksPermi�N <br /> PE R M 1 T Building Permit q <br /> PUBLIC WORKS DEPARTMENT Planning Reference# <br /> 3200 Cedar Street <br /> Everett.WA 98201 Public Works Fee 5 <br /> (425)257-8810 <br /> Guarantee 5 <br /> �OLNNER NAIdE APP�ICANi NAME <br /> � AHDA�DRESS: , � AN�ADDRESS: <br /> i �HONE: .. PHONE: <br /> ITA%PARCELI.D# PROJECTAODRESS: <br /> DESCRIPTION OF <br /> PROPOSED WORK: <br /> I. <br /> PERMITCONDITIONS : � <br /> 1. All calls for inspection shall be made 24 hours in advance. <br /> 2. All work shall be performed in accordance with this permit and current City o(Evereq Design and Consiruction <br /> Standards and Speciticalions. <br /> 3. Call Localion Underground Service 48 hrs. before you dig.TOLL FREE NUMBER 1-800•424-5555 �` <br /> _ r <br /> . .� . �.� . . . _ . _ . :�. . .. . . _ . . . _ .: ._ � . � <br /> . _ _ . . . . � . - v.d i �=" } � � �� . t�ie c'. .,t ;r,�.�,i i -.. . . fl\ <br /> . . . ... � .i �._t'�� ft'CIq TrpI1�7.:it U ❑ '31���-v.,1.k 811�9 ��V1VaV3�f. .511�, . . . � �// <br /> � . �:��. � j �. i_. •:rc i _ it , b- � ;, :;n7 nf m_•t��n7i is ali,-�4+e�!l�nn ihf r ":rny . W <br /> 11Lr� 2�13. LJ:�:� .�L i�b� -- '- -__...��� �,nr_� r 3��!$:r i �r-r ..� ��. <br /> - y O' � r r-1 �:} �i� �o. <br /> ._1a IP,-'�" 1..' . : f:-_� t�.:.� �.t_ ... I'i : <p _ i c ���ry_%��� �T1, <br /> � � .� .. .. . . . . . __ . - 1. __ _ � <br /> Z <br /> O <br /> H <br /> � <br /> O <br /> a <br /> � �a ��cri�r_�z ��= <br /> I _ ,� ACKNOWLEDGEMENT OF COVDITIONS <br /> - � The undersigned ownerlapplicant hereby agrees lo hold and <br /> li <��j`�` �i�_� "� fJ; ��`� save harmless the City ol Everett Irom any and all claims lor <br /> t � <br /> p ro ea lor Consimction lo damages,costs,ezpenses,or causes of action that may arise <br /> i,�i%� C/JlL= F�'2 �/N�1G —' W�'rk ���rF����ecause ol inslallation and maintenance ol the impmvement or <br /> / � other righFol-way use hereto applietl br and fudher agrees lo <br /> ���� _ ����l,�'—_ �`�I� �v remove s�me upon notice from Ihe City and to replace pubiic <br /> � �GlNR RJSPECTION � / property da �aged thereby. <br /> ' � Appmvetl as Conslmcicd Oa�e <br /> 1J / 7 <br /> . — SignaWreolApplicant Date <br /> l';ORK AUTHORIZED BV THIS PERMIT h1UST BE STARTED WITHIN 180 DAVS OF DATE PEFIdIT IS ISSUEDAND THEREAFTER IS TO BE OILIGENTLV PURSUED <br /> 70 COM1IPL[TION.THIS PERMIT MAV BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORI(ON THIS PflOJECT OVER 90 DAYS DURATION. <br /> LPCJP(,-Oul �.9A9AR.INC <br />