1501 RAINIER AVE 2016-01-01 MF Import

C�� TYPE OR PRINT ONLY ,�r Owner Application For PUBLIC WORKS PERMIT Describe Proposed Work .,i—P _ _ I L^ �� PROJECT ADDRESS (if known) PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett, WA 98201 259-8810 / ��Y / Date �— � ` `" ' Public Works Pertnit k �tl �8O Building Permit 8 n ab Public Works Fee 5 d � - � � B�_� �-, rn_l;e��n Zip Atlach four (4) copies ot plans for proposed work - Draw to scale and note the fo�iowing if applicable: •Property Lines "Outline and tlimensions of all existing and proposed sfructures on the lot •Existing and proposed utilities 'Centerline of street •Indicate North 5how any proposed grading chan9es •Show measurements / PERMIT CONDITIONS: 1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. 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 1-800-4245555. 7, LUor.� �`0 6a �%r„�- f�.=�" cSG.oi-oveo� e%tiz�%�, f oa�iz a� s��96 �� Approved as Constmcted ( j' (> -Y l f OS/OB/96 4.09fM I / M00096180 pTHEft s'�o.00 CHECY. s^0.00 W � �//� V♦ ��A V♦ � a K:k:k:t ACKNOWLEDGEMENT OF CONDITIONS Thc undersigned owner/applicant hereby agrees to ho�d and save harmlecs the City of Everett from any and all daims for damages, costs, expenses, or causes of aclion that may arise because of installation and maintenance of ihe improvemer,t or other righl•of-way use heieto applied for and fuAher agrees to remove same upon notice from the City and to replace public property damaged thereby. �r' .� � �P�� -�^`i� Signature of Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED ANU THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVEF 90 DAYS DURATION.