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,.- <br />r "• .;::' <br />��r,•:-. ; . <br />�y�! `>:: . <br />�•k <br />PUBLIC WOltKS PERMIT <br />City of Everett Public Works Department <br />3200 Cedar Street <br />Everett, WA 98201 <br />(425)257-8810 <br />Date: 7 /1 812 01 2 <br />PublicbNorksPermit#: PW1207-019 <br />Buildinp Permit#; Gi�o� - ��a <br />?lanninq Reference #: <br />Public Works Fee $: $ 25.00 <br />nther 5: <br />OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br />53RD AVENUE WEST LLC <br />677 120TH AVE. N.E. #2-A Ol...'Y�2'r <br />f3ELLEVUE WA 98005 <br />PHONE: 2066506770 PHONE: <br />TAX PARCEL ID # SITE ADDRESS: 4503 GRAND AVE. LoJ 3 <br />OESCRIPTION OF PROPOSED WORK: <br />C9k AT N`c.G'LJ ��� � � <br />(71181_012 10:50 AM BES) <br />CONSTRUCT PER APPROVED <br />SHORT PLAT 1202-40-07 <br />PERMIT CONDITIONS <br />1. All calis for inspeclion shall be made 24 hours in advance. <br />2. All evork shall be performed in accordance with the permit and current Ciry of Everett Design and Construction Standards <br />and Specifications. <br />3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 � <br />4.CONSTRUCT PER APPROVED SHORT PLAT. <br />_ -- —� \ Lt ,/1,�; / �P / � !v <br />q"pprove for Co str� � ion , Date <br />c,✓L �'�G -� —// J <br />INAL INSP TION Date <br />Annmved as Constructed <br />TO POSTING 3 � � �3 �� <br />w <br />H <br />� <br />� <br />� <br />O <br />� <br />z <br />0 <br />H <br />� <br />0 <br />a <br />ACKNOWLEDGEh4ENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees lo hold and <br />save harmiass fhe Ciry uf Evemtt hom any and all daims for <br />damages, cosis, expenses, or causes of action lhal may arise <br />because ef inslallalion and mainlenanca of lhe improvement <br />or other right-of-way use herelo appii�d for and furiher agrees <br />to remove same upon notica irom ihe City and to repiace <br />public property damac�ed U�ereby. <br />� � u.r.,., �c ".<iv�`-t" 7/ � `�/ � Z <br />Signalure oF Applicanl <br />Dale <br />WORK AUTHORIZf:D 6Y TI115 P[RD1IT h1U5T 6[ SiARTED W1TH W l80 DAYS OF DATE PERPIIT IS ISSUED AND THEREAFTER IS TO BE DILIGEWTLY <br />PURSUEU TO COFIPL[TIOW. TNIS PERf41T hL1Y (3E UNCELLED EiY TH[ CITY UPON ANY STOPPAGE OF WORK ON THIS PRO]ECi OVER 9U DAYS DURATI�N. <br />