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PUBLIC WORKS °a'e `'' �''"` <br /> Public Works Permit;1'h�'c:'-�—"''' , <br /> PERMITBuildingPermitN n�ti��-�ti4 <br /> PUBLIC WORKS D[PARTMEIJT Planning Relerencc# <br /> 3200 Cedar Sireet <br /> Evere��.WA 98201 Pu61ic Work;Fe,e 5 :,_° .'.'i i <br /> (4�5�5f �'�TlNG �uN o s zoos Guaranlee S <br /> Ol7NE�7NA�F:� LISA APPLICANTNAME <br /> nND4DDR[55'�" �ND ADDRESS�. <br /> 1_17 RUCy.iF. AV£ <br /> E'.'EFvSTT ',:. ?'�i_,..' <br /> Pi+oNe� 9�53495944 ���omr:�. <br /> TA%PARCELID.Ci�G-`F`yaiiila:�.. PFiOJLCTADDRE55:1� L.G.:._F. A\T <br /> DESCRIPTIONORIF'j'p,�(?$[, �_j.T.,-.,_::: <br /> PROPOSED WOqK- <br /> PERMIT CONDITIONS <br /> 1. All calls lor inspection shall be made 24 hours in advance -phone (425) 257-8810 <br /> 2. All work shall be performed in acwrdance wiRi this permit and currenl Ciry of Evere�l Design and Conslruction <br /> Standards and Specilications. <br /> 3. Call Location Undergrou'.j Service 48 hrs.before you dig. TOLL FREE NUMBER 1-800•424-5555 <br /> 9 F . _ I-. .. .__ c : t _a: '_.� �c�_ F _'.t n:t ... . ::�.,� !�.i � t '�k .�... , _ , r <br /> '_' . _❑ .L'., 1: , iI _.�-C 1: t:.. i � , ❑.t . . . , .,�.C•.1 ., .,i ] . _—_. . _ <br /> ,�il�e�l ?�. _ . ... ..'.It. ,•i lf C:. ,r11��. :';i,_ ���,�� _ _i:. fA <br /> ;:,: . .. , . :. , ; N/ <br /> flys�c���E �,�v/ovs ._z,isP�zo� /�s .��e�r�. il.�r ,9>3e� m <br /> 7v l�E�i F�.� �"�/�E CcrniFr� ��rz��7c7rJ� �t/o A��-✓jc��c.rs . �4 S/7s/�,G � <br /> 7 <br /> Z <br /> O <br /> H <br /> � <br /> O <br /> a <br /> ACKNO'VLEDGEMENT OF CONDITIONS <br /> ��G� G CGC/3Y J' / —� � The imtlersignetl own,r:applicant heieby�grees�o haid and <br /> save harmless ihe Cit of Evemit Irom an �nd all claims lor <br /> �pr �icr ca�s�mceon Date dama9es,cosis.expenses,or causas ol action Ihat may arise <br /> bewuse ol installation and maintenance of the impmvement or <br /> �_����' � Z S � b o�her right-of-way use hereto apptiea lor and turthcr agrees to <br /> remove same upon notice from the Ciry and to replace public <br /> FINAL I PEC property damagetl thereby. <br /> ApProvua ds ConslruclCd Dale <br /> S��gnatureufApplicant Datc <br /> 1l:�RH�UTHORI7F�[lV iHly P[i1M191 IdUST BE STARTED IVITIIIN iD0 UAVS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENiLY PURSUED <br /> io COtAPLf°iln�! '!us PI�RR,i I IdAy[iH CANCELL[D OY�HE CITV UPON ANV S70PPAGE OF WOflK ON THIS PROJEGT OVER 90 DAYS DURA710N. <br />