2015 VIRGINIA AVE 2016-01-01 MF Import

�� TYPE OR PRINT ONLY � App�lcatbn Fm PUBLfC V1fORKS PERMIT PUBLIC WORKS DEPARTMENT 3200 Cetlar Street EvereH, WA 5'0201 259-8810 __, POSTiNG ►+ov 3 u 200� oa�e — Public Nbrks Pertnit N 8uilding Pertnit N _ Public Nbrks Fee S _ 1/20/99 FRANKS MATT 6 IJ+URIE 2015 VIRGINIA AVF. EVERETT 98201 425-258-2859 Ow.rer MailingAddress City Zip Phone CONT:ICT: ED OLSEN 259-1311 Applicant Mailing Address City Zip Phone � Describe Proposed Vwi k PROJECT ADDRESS (if known) : �I�YIZl7:1'7;� Atlach four (J) wpies of plans for proposed work - Draw to s.;ale and note the foilowing if applicable: •Pmperty Lines 'O�tlinc and dimensions of all exi5ling and proposed structuros on the lot •Fxisting and proposed utilities •Centerline of streel "InAicate Nortli 'Show any pmpnsed gradin� changes •Show measurements PERMIT CONDITIONS: 1. All calls for inspe�tion shali be n±ade 24 hours in advance - ohona 259-8810. 2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction Stindards and Specifications. 3. Call Location linderground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � %�,�/P�f' �I�Tit�l��'/ �G'iM�� virP,G�. C�,�� ,�,�5 -� s; �� Approved for Consiruction Date FINAL INSPEC710N Date Approved as Constructed ACKNOWLEDGEMENT OF CONDITONS The undPrsi�ned owner/applicant hereby agrees to hold and save hartnless the City of Everett from any and aG cialms for damages, costs, expenses, or causes of action that may aiiso because oi installation and Taintenance of the improvement a other rigli�-oi-way use here�o epplied for and further egrees to remove same upon notice hom ihe City and ta replxe public property damaged thereby. Signature of Applicant Date V.'ORK AUTHORIZED BV hi15 PERMIT MUST BE STARTED WITHIN 180 OAYS OF DATE ?ERMR IS ISSUED AND THEREAFTEP IS TO BE DILIGENTLY PURSUED TO COMPLEf10N. 7H15 PERMIT MAY BE CANCELLED BY THE CIIY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAVS WRA710N.