6007 ROCKEFELLER AVE 2016-01-01 MF Import

Date�� �pplication For PUBLIC WORKS PERMIT Print or Type Only a�v Describe Proposed Work Project Address (if known) Puel�c Worka Permit (•� Bltlg. Deo�. � — � fG �� 7S � —� - / a�on� wo�w� Fwa — iotsi Fee S lesa AppL Fee Peid S Belanca Oue .i 35S- .�7�,�_ Z�P Phone � 4sa�n G� Z�P Phone � f0 Altach lour (4) copies of plans for proposed work • Draw to scale ano ote the following as applicable: • Property Lines • Outline and dimensions of all existing and proposed structures on thz lol • Existing and proposed ulilities PERMIT CONUITIONS • Centerline of street • Indicate North • Show any pmposed grading changes �� Show measurements 1. All calls for inspection shall be made 24 hrs. in advance - plione 259•8815. 2. All work shall be performed ir accordance wi,h this permit and current City of Everett Oesign and Construction Stsndards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•8Q0•424•5555. �pr��it u�o,�,�s PE,��T .var ,�Eq v.,�F� Approved lor Construction Date FIN.4L INSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everett. WA 98201 Phone: 259-8815 /z-9-8� �� ACKNOIJL�DGEMENT OF CONDITIONS W � w � � O � � 0 a The undersigned owner/applicant hereby agrees to hold and save ha�m• less the City of Everett trom nny and all claims lor damages, cosis, expenses, or causes ol action that may arise because ol installation and main!enance of ihe improvement or other righFot•way use hereto applied for and further agrees to �emove same upon notice irom the City and to replace public property damaged Ihereby. Signalure of Applicant Date WORK AUTHORI2ED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PEfiMIT IS ISSUED AND 7HEREAFTER 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 DAVS DURATION.