2818 GRAND AVE 2018-01-02 MF Import

Appl-Callon For PUBLIC WORKS PERMIT Date PUBLIC WORKS DEPARTMENT T Public Works Permit If 7 ,Q 43 3200 Cedar Street Everett, WA 98201 259-8810 Q () Building Permit M TYPL OR PRINT ONLY Public Works Fee $ �Z� 00 !�i Nr • BK Noc vsr �i1gi�0Es/c/•1 �c�9yltlt� U/� t�/�Cv7 yZ5 i�1%S�� Owner Mailing Address '--t City Zip Phone P /, le Tip AIL51rI ff"7 1/25 iy%5�6- Applicant Mailing Address rly City Zip Phone o a o Describe Proposed Work 7d/ - So '0tK4-f !LC4 d 4(L SiU� 6F Lf�i� ■ ■ ■ y ,Sc4uR / 7V e 417,C,#14 Zas t//LE .o ( . S/ o / 930 vev�f/ (e e'o 011 4k. PROJECT ADDRESS (if known) -�79/e X.l�l/3 o Attach four (4) copies of plans for pmn�sed work - Draw to scale and note the following if applicable: •Propedy Lines 'Outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities O -Centerline of street "Indicate North •Show any proposed grading changes •Show measurements DO NOT WRITE BELOW THIS LINE PERMIT CONDITIONS: 1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. O 2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. Ile 7o�� /fj�s 7i�r� lS l��vir�J 6y Co� e�i�ovCehie•,7� �� J{ate fi�r��sr spy ah 7<<i:.r /?"a/oe.-f y FINAL INSPECTION Approved as Constructed Date ACKNOWLEDGEMENT OF CONDITIONS The undersigned ow,ier/applicant hereby agrees to hold and save harmless the City of Everett from any and all claims for damages, costs, expenses, or causes of action that may arise because of installation and maintenance of the improvement or other right-of-way use hereto applied for and further agrees to remove same upon notice from the City and to replace public property damaged thereby. i Signature of Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED i.ND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.