4511 SEAHURST AVE 2018-01-02 MF Import

DateA y • *1 Public Workg Permit a Application For Bldg Dept.a li!7:r/_X:5��77 PUBLIC WORKS PERMIT Print or Type Onit 50 �j0ANU P_,1�T Public Works Fee $ Total Fee Less APpt Fee Paid $ Balance Due $ �7 962o3 a5-z-470 Owner Mailing Address - City �� Zip �.-1 Phone PpI_'AN`JGN 0/111TEn 1&z314 QZ� L�rNNU: o,d iQ 57 %78—NCO Applicant Mailing Address ity Zip Phone Describe Proposed Work Ty 0'2E FXI5-T r6-,, BLL D4:4 r x. Project Address (if known) Attach four (4) copies of plans for proposed work- Draw to scale and note the following as applicable: • Property Lines • Outline and dimensions of all existing and proposed structures on the lot • Existing and proposed utilities • Centerline of street • Indicate North • Show any proposed grading changes • Show measurements PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hrs. in advance - phone 259.881 5. 2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1 -600.424.5555. Approved for Constructiun Date FINAL INSPECTION Date Approved as Constructed everett PUBLIC WORKS DEPARTMENT Ever Cedar Street Everett, WA 98201 Phone: 259-8815 ACKNOWLEDGEMENT OF CONDITIONS z 0 0 a The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett from any and all claims for damages, costs, expenses, or causes of action that may arise because of installation and maintenance of the improvement or other right-of-way use hereto applied for and further agrees to remove same upon notice from the City and to replace public pr perty dafnaged thereby. �� 4h%i,U %-5- algnaiure or Hppncant ��•_ WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE C:TY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.