1531 PINE ST 2016-01-01 MF Import

�A fn � ` PUEiic Wo�ks Perm�t• Date Cl Y� �`�J /!. �� AppliCeilon For BiaQ neo� +�t.� f!!� PUBLIC WORKS PERMIT P��'�WorbFee Totel Fee s Less�p0�Fee Peid S Bebnce Due f Print or Type Only wner Mei4ing Address City Zip Phone � J Applicent Meiling Address City 2ip Phone Describe ProOosed Work �f''!'= � � r� �� W �� ,�j 3l l�;.�a .$'f" � Pro�ect Address(if known) Attech four(4)copies of plens for proposed work• Draw to scale and note the lu�lowing as applicabie: � • Property lines • Centerline of street � • Outline and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities � • Show measurements M W DO NOT WRITE BELOW THIS LINE O PERMIT CONDITIONS 1. All calls for inspeotion shall be made 24 hrs in advance-phone 259•881 5. � 2, All work shall be peAormed in accordance with this permit and current City of Everett Design and Construction Standerils end Specifications �3. Call Location Underground Service 48 hrs.belore you diy.TOLL FREE NUMBER 1•800•424•5555. � No ��e �,� �d,�� ,<T ,�F . O � /Z/�6 H � � O a ACKNOWLELGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harm• less the City of Everett trom any and all claims for damages, costa expenses, or causes of action thal may arise because of installation and maintenance ol the improvement or other right•of•way use hereto applied for and further agrees to remove same upon notice Irom the Approved for Conslruction �a�e City and to replace public property damaged thereby. FINAL INSPECTION Date Date Approved as Constructed Signature oi Applica�t WORK AUTHORIZED BY THIS PERMIT MUST BE STAfiTED WITHIN everett PUBLIC WORKS DEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO � 3200 Cedar Street BE DILIGENTLY PURSUED TO COMPLET�ON. THIS PERMIT MAY BE Everett,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS Phone: 259�8815 PROJECT OVER 90 DAYS DURATION.