1105 PACIFIC AVE 2016-01-01 MF Import

��-i PUBLIC WOi2KS PERMIT Date: 3/10/2011 Public Works Permit#: PW1103-008 (/ Ciry of Everett Pubiic Works Department guilding Permit#; 3200 Cedar Street ��t�� Everett, WA 98201 Planning Reference#: (425) 257-8810 Public Works Fee S: S 335.66 Other 5: OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: PUGET SOUND KIDNEY RAEF CHRIS 1019 PACIFIC AVE EVERETT Wq 98201 EVERETT WA 98201 PHONE: 4�52595195 PHONE: 4252590868 TAX PARCEL ID# 00437572201100 SITE ADDRESS: 1105 PACIFIC AVE DESCRIPTION OF PROPOSED WORK: CREATE EMPLOYEE PARKING LOT PERMIT CONDITIONS 1. All calls for inspection shali be made 24 hours in advance. 2. AII work shall be performed in accordance�vith the permit and current Ciry of Everett Design a�d Construction Standards and Specifications. 3. Call Locatian Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 4. CONSTRUCT PER APPROVED PLAN. w _• _ H `:1; ' = _ �-'- V1 � h � � .,'16J :-f 2:} •/1 �' . Vl �, O ii � -' . _, .. _ a TO POSTING �� ACKNOWL[DGEMENT OF CONDITIONS � The widersigned ownedapplicant hereby agrees lo hold and ! save harmless the Cily of Everett from any and all claims for � '.� � damages,cosls,expenses,or causes o(action that may arise p / / because of installalion and maintenance of the improvemenl � I� ^,�.� !� �� ;�� or other righFof-way use herelo applied for and further agrees ��` Y% to remove same upon nolice from the City and to replace �pp ed o�Gons i � Date public property damaged Ihereby. ��.. .�`�' .� �- 1z- �3 � INAL INSPE T'ION Date n' '"' —�— Approved as Const�ucted Signalure of Applicant Date 1':CRK AUTHORIZC.D 6Y THIS f ERFiIT IdUST 6E STARTED IVITHIN 1f30 DAYS Of-DATE P[Rh11T IS ISSUED AND 111EREAfTER IS TO BE DILIGENTLY f�URSUED l0 COhiPLE7l0IL TH15 PERIdIT I•1AY�E CANCELLED tiY TH[CITY UPON ANY STOPPAG[OF WORK ON THIS PROJECi OVER 90 DAYS DURATIO�J.