929 PINE ST 2016-01-01 MF Import

Date�C/�Lc�� � • t Application For PUBLIC WORKS PERMIT Print or Type Only LZp.� T Mailing Address �� � Pu�lic Woihf Parmil • �/�— ��f eiee� oao�� • �L Pubbc Works Fce Totel Fee s Less PpP� Fae Peltl S ��J Balanca Uue s y ✓ — t 2i3 2/5/ Phone �rz� zsz -z9 �b � Phone Describe Proposed Work _�LE.�g�QL�a -� ��r1,f(y��e/ — {t� .ss„ �= _� Prolect Address (il known) Attach four (4) copies of plans tor proposed work - Draw to scale and note the following as applicable: • Property Lines • Outline and dimensions of all e;�isting antl proposed structures on the lot • Existing and proposed utilities • Centerline of street • Indicale North • Show any proposed grading changes • Show measur.:ments PERMIT CONDITIONS 1. All calls for Inspection shall be made 24 hrs. in advance • phone 259-8810. 2. All work shall be Vertormed in accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. befoie you dig. TOLL FREE NUMBER 1•800-424-5555. �..�'� �ro�- 8��a - Approved br Conslructio� Date � � -d 3 - d'7 FINAL INSPECTION � ' Date Approved as Consiructed evere[t PUBLIC WORKS DEPARTMENT � 3200 Cedar Sireel � Everetl. WA 98201 Phone:259-8810 ACKNOWLEDGEMENT OF CONDITIONS W � � � � O � � O a The undersigned owner/applicant hereby agrees to hold and save harm- less Ihe City ot Eve�ett irom any and all ciaims for damages, costu expenses, or causes ol action that may arise because ol instaltation and maintenance ol the improvement or other righbohway use hereto applied lor and further a es to remove same upon nutice from the City and to replace pub�operty damaged thereby. nature ot applicant Date ORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHI�� 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.