3000 ROCKEFELLER AVE COURTROOMS 2018-01-02 MF Import

Application F of PUBLIC WORKS PERMIT Print or Type Only Mailing ill Public Works Permll(�a Bldg. Deril a •r `] Public Works Fee Total Fee S Less appt Fee Paid $ Balance -,Due $ Zip Phone Describe Proposed Work %t 0&1 (`d,,- "= 441 VA _St%t 1101 1241 i(u,f f )10//S V_ LU Project Address Id known) �� 0 �� p-tv✓-"1 ___—__-- Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable. Ittlttttt� • Property Lines • Centerline of street • Outline and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed grading changes • Eki:.ling and proposed utilities • Show measurements DO NOT WRITE BEL )W THIS LINE O PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hrs. 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, bi-fore ycu dig TOLL FREE NUMBER 1-800.424-5555. ` `1°�" O a Approved for Construction Date FINAL INSPECTION Date Approved as Constructed 11 reerett PUBLIC WORKS DEPARTMENT 3200 Ceder Street Everett. WA 98201 Fnone: 259-8810 ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett from any and all claims for damages, costs, expenses, or causes of action that may arise because of installation and maintenance of the, improvement or other right-of-way use hereto applied for and further agrees to remove same upon notice from the City and to replace public property damaged thereby. Signature of Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE dERM1T IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.