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� � PUBLIC WORKS °''3°'2°°1 <br /> � Date <br /> Public Works Permit x PW0107-035 <br /> PERMIT BuilCingPermitN C0107-��� <br /> PUBLIC WORKS DEPARTMENT Planning Reference N <br /> 3200 Cedar Sireet �U. 00 <br /> Evoretl,WA 98201 Public Works Fee$ <br /> `°z5,25'�,�-uSTING _ "�v z � LU�L Guaramce5 <br /> OWNEFNAME 5S l. NS APPLICANTNAME <br /> ANDAODRESS�602 RUCKER AVE ANDADDRESS: <br /> EVERETT WA 98201 <br /> PHONE: � 4�-`') ?59-3984 PMONE: <br /> TAXPARCELI.D.N � PROJECTADDRESS: " <br /> DESCRIPTIONOF ADDITZON/REMODEL <br /> PROPOSED WORK: <br /> PW <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection shall be made 24 hours in advance- phone (425)257-8810 <br /> 2. All work shall be performed in accordance with �his permit and currenl City of Everett Design and Construction <br /> Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424•5555 <br /> 4. CHECK r_ONDITION OF EXISTING SIDE SEWER ( 1910) - - W <br /> 5 . PLUMBING PERMIT ISSUED TO REVISL SIDE SEWER UNDER NEW PORTION OF � <br /> BUILDING. _ _ : '�A <br /> _ __ V/ <br /> -_ �G•, W <br /> __ .._68._ O <br /> --n.,' <br /> Z <br /> O <br /> H <br /> N <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> !' —] I The undersigned ownedapplicant hereby egrees to hdd and <br /> ( save harmless the City of Everett from any and all daims for <br /> ovea ior Co vumi Dat Oamages,costs,ezpenses,or causes ol action that may adse <br /> i, because oi installalion and maintenance of ine improvement or <br /> i- O i '�,.o� other rightol-way use hereto applied lor and further egrees to <br /> � remwe same upon notice iran the City and to replace puhiic <br /> Fl � �ON ptepe(ly damaged C �i <br /> App�oved as Consvuae0 Data � � 9 �1 I �3 �� � <br /> •�../ <br /> Signalure at Appli[ant Dale <br /> WORK AUTMORIZED DY THIS PERMIT MUST BE STARTED WIIHIN 180 DAYS OF DATE PERMI7151SSUED AND THEREAFfER IS TO BE DILIGENTLY PURSUED <br /> TO COMPLETION. iHIS PERMIT MAV BE CANCELLED BV THE CITV U�ON ANV STOPPAGE OF WORN ON TIIS PROJECT OVER 90 DAYS DURA710N. <br />