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� .,�« -� L` _ <br /> PUBLICWORKS PublicWorksPermitM C•W��� � - <br /> PERMIT i BuildingPermil/+ - ''- <br /> PUBLIC WORKS DEPARTMENT Plamm�g Relerr.nce N <br /> 3200 Cedar Sireet <br /> Everett,WA 98201 public Wmks Fee 5 � • •� <br /> (425)257-8810 <br /> Guarantee S <br /> OWNER NAME APPLICANT NAME ,�.� ,�,; <br /> ANDAODRESS. � . '. . 't:i '� . , '.��.'� - (.... . ANDADDIlESS: i�=i":" <br /> �. rti�zL��� RLVU <br /> . _:�rT kiT. �5:r�i <br /> PHONE: �-:�.:.:_"c... PHONE: 1_'- . `. .� _ <br /> TA%PAFCELI.D.N — PROJECTADDRESS: . ..=: ;,� , — _� <br /> DESCRIPTIONOF . . �. .� . - , . �.r:�.. .. . . . . <br /> PROPOSED WORK � -� � <br /> PERMIT CONDII IONS <br /> 1. All cails for inspeclion shall bc tnacie ,'.4 hours in advancc. <br /> 2. All work shall be pertonned in accordance with���is permit and current City uf Evere�t Desgn and Consiru�Gon <br /> Slandards and Specilicalions. � <br /> 3. Call Lor.ation Underground Service 48 hrs. belore you dig.TOLL FREE NUMBER 7-800-424-5555 � <br /> � <br /> N <br /> m <br /> � � ir. � . " ,� .: ,. : :.�,: _, r ::��� �.: ��; :� .� .,t . i .,,_ :�. . . � . �� .. . . � � . . <br /> .�.. -, . .,. . : . .. . O <br /> r main hnx locate�i about 54' to rhw v��i . IACE :1I+OIAl�I be ta�.- .. �. , . � � . . , . " ' <br /> - 9*CUrtUC89. PB suce to call the underae�und locate aee��ir.. - . -� - <br /> ._l'tartlOA. :'�@0 9{i?8t L�..i. Z <br /> . �'::�ep ciky �lreets clean aL sll timee. , O <br /> �v�de er��aion control a� ^tipuleted by th� - _ - <br /> ' '�1j �'A <br /> V+ <br /> O <br /> a <br /> -- --- — i ACKNOWLEDGEMENTOFCONDITIONS <br /> The untlersigned ownedapplicanl hereby agrees to hold and <br /> �% .� r save hannless the City ol Everetl irom any and all claims for <br /> "-l�• �"��� ���� � "f`����� � ` damages,costs,expens�s,or causes ol action Ihal may arise <br /> nppmvea Ior Cons�maion Date because ol installation and maintenance ol the improvement or <br /> olhcr right-of�way use hereto applied for and funher agrees to <br /> removo same upon notice irom the City and to replace public <br /> FINAL INSPECTION propetly tlamaged Iherbby. <br /> Approvetl as Conslmaed Dab � � , . , � � - " <br /> � _ _ Sic�nalure ol Applicanl Oale <br /> 7J0 COMPLC-T�ION.7�iIS PERM TFMAV BE CANC ELLED OV TNE�CITY�UPON ANY�5 OPPAGE OP WORK ON THIS PROREC OVER 90 DAYS IDURA IONPUFSUEO <br /> OFTA�AR,INC. <br /> er�vr inos� <br />