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0;:7r Apn,catimr Fm Date 3-13-97 <br />PUBLIC WORKS PERMIT L� <br />PUBLIC WORKS DEPARTMENT Public Works Permit # - / �0 LO <br />3200 Cedar Street ���///��/ <br />Everett, WA 98201 259-8810 Building Permit # _.may 5z�'-- <br />g, n c�'lti�y OCT 0 6 1997_ / <br />i Pi <br />TYPE OR PRINT ONLY Public Works Fee S --- <br />Theo Construction Inc PO Box 2065 Bothell 98041 486-7643 <br />Owner Mailing Address City Zip Phone <br />Owner <br />Applicant <br />De,cribe Proposed Work new <br />Address <br />PROJEC i ADDRESS (if known) I(V I I � I r� —in a <br />City <br />Phone <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following if ,applicable: <br />•Property Lines •Outline and dimensions of all existing and proposed stn:ctures on the lot "Existing and proposed utilities <br />-Centerline of street "Indicate North •Show any proposed grading changes •Show measurements <br />PERMIT CONDITIONS: <br />1. All calls'or inspection shall be made 24 hours in advance - phone 259-800. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service,18 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />,4-. Ins-1-4 Gl �k �''� �✓ ✓ Ivc i �i ,- <br />90P <br />' L C..e.� <br />Ap for Consiru ion <br />3/2� <br />Da <br />roved <br />Y1/ <br />AL INSPECTION <br />Date <br />Approved as Constructed <br />CHECK $2891.73 <br />W <br />Cl) <br />ca <br />O <br />z <br />O <br />i <br />O <br />a <br />0921*C0NTINUE* <br />04/23/97 11:42At1 OOOAA0921 K0 <br />J <br />#00054504 <br />103 M30.23 <br />ACKNOWLEAMENT OF 6NEPPONS <br />The undersigned owner/appiicME(Nreby agrl6DoXId and save harmless <br />the City of Everett from any a.96KNRpns for :4 , costs, expenses, or <br />causes of action that may arts 6e of i�v-Mar and maintenance of <br />the improvement or other nyht-�,g hf�reoapbi for and further agrees <br />to remove same upon notice � and to replace public property <br />damaad -thereby. i4dR,TEF $650.00 <br />$70.00 23-g <br />'KCOPP�fMJE# <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DAMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />