2222 ROSS AVE BASE FILE 2018-01-01 MF Import

Date u y Application For PUBLIC WORKS PERMIT Print or Type Only Mailing Describe Proposed Work Project Address lil known) City Clry Zip PuGLc Worka Pnrm�t • �/ �1 —' v�O Bitlp. DeD�. • �,�7 D � PuElic Workf Fee Tolel Fee s Leaa Apol Fee P�id S OelenceDue .S �� Attach lour (A) copies ol plans �or proposed work - Draw lo scale and note the following as applicable: • Property Lines • Cenlerline of street s Outline and tlimensions of all existing and • Indicalc North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements for Phone PERMIT CONDITIONS l. All calls for inspection shall be made 24 hrs. in aAvance - phone 259•881 5. 2. All work shall be performed in accordance with this permit and current City ol Everett Design and Construction Slandards and Specifications. 3. Call location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424•5555. � �S'iTF Gvca�.e io b'F �oti� PE� ,9P,oc�c�cF-O P�S',� t19.2� 5�zz Bti ACKNOWLEDGEMENT OF CONDI710N5 W H � � O � � O a The undersigned owner/applicant hereby agrees to hold and save harm- less the Ciry ot Everett irom any and all claims for damages, costs, � expenses, or causes ol action that may arise because of installation �/ �� and maintenance of ihe improvement or other righFol�way use hereto � applied tor and further agrees to remove same upon notice irom the Date City and to replace public property damaged thereby. �`�'� Ea�� F-/�- �-.1 FTAL INSPECTION Date Approved as Consiructed evcrelt PUBLIC WORKS D[PARTMENT � 3200 Cedar Street Everett, WA 98201 Phone: 259-8815 WORK AUTIIORI�ED BY HI PERMIT MUST BE STARTED WITHIN iB0 DAYS OF DATE PER IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPIETION. THIS PERMIT MAY BE CANCELLED BY THE CITV UPON ANV :iTOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.