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PUBLIC WORKS PERMIT Date: <br />, (FkI) 15:5Public Works Permit #: <br />Ci of Everett P VJorks De���� p����2 Buildinq Permit #; <br />ty 3200��r Street �i� t <br />E (4rZe�� WQ ,98�op1��� �Pl2nning Reference #: <br />�5� g@ B <br />Public Works Fee $: <br />1 F1C_ E21.R4 Other g. <br />OWNER NAME AND ADDRESS: <br />HOANG LISA <br />1433 W MUKILTEO BLVD <br />EVERETT WA 98203 <br />PHONE: 4255057407 <br />'AX PARCEL ID # 00505700002702 <br />DESCRIPTION OF PROPOSED WORK: <br />ADDITION + 2 CAR ATTACHED GARAGE <br />8/19/2011 �� <br />PW1108-019 <br />C1108-007 <br />$ 25.00 <br />I1ECN APPL�1� NAME AND ADDRESS: <br />F'LBG SB0.00 <br />DRIVE 52�.00 <br />S C 54.5�J <br />p 110811b <br />ELEC pHOt�•� <br />��. '. <br />CARD SH�l1[i4lB!RESS: 1433 W MUKILTEO BLVD <br />PERMIT CONDITIONS <br />1. All calls for inspection sh211 be made 24 hours in advance. <br />2. All work shall be performed in accordance with the permit and current City of Everett Design and Construction Standards <br />and Speciflcations. <br />3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 � <br />4. The contractor must meet with the Public Works Inspector to discuss potential drainage routing prior to beginning <br />the project. CALL RANDY ALLEN AT 42G-339-7403. <br />5. All excavated material from foundation, sidewalk and driveways shall be hauled to an approved, permitted site. <br />No wasting of material is allowed on this building lot. <br />6. No dirt, mud, rocks or debris to be tracked onto roadway. <br />W <br />� <br />� <br />0 <br />�7 <br />z <br />0 <br />H <br />� <br />0 <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and <br />save harmless the City af Everett from any and all claims for <br />damages, cosls, expenses, or causes of action that may arise <br />because oi installation and maintenance of the improvement <br />ar other righl•of-way use hereto applied for and further agrees <br />to remove s e upon notice from the Ciry and to replace <br />pGBfjc prop damaged thereby. <br />I / k I l� /�l <br />of Applicant <br />Date <br />WORK AUTHORIZED BY lNlS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND 1}1EREAFIER IS TO BE DiLIGENiLY <br />PUP.SUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PRO:E�?' OVER 90 DAYS DURATION. <br />