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(�i__`� PUBLIC W KS PERMIT °�- <br /> sii <br /> PUBIJC WORKS DEWIRTMENT PuEW_.Nbrlu PxmR R <br /> 3200 Ced�r StraN <br /> Eve'elt,WA 98201 259-8810 <br /> BuAdk�p PennM 11 <br /> TYPF OR PRINT ONLY p��y���_ <br /> Plpan Chack No: B 6/075/6 68PA <br /> �« �PJob Addr��s 32b65kAVR UR �ne <br /> Owner: BALDWIN :.71FtAY/DONNA <br /> T�nant: <br /> ����� Proposed Uaes BFR/DP,C1C p�e <br /> Deec, of Norki <br /> DfiCR ]1DDITION <br /> Describe Proposed Work_ � � <br /> OFFICE SET J08 SET <br /> ]1PPROVSD FOk PBRNITt DATS_/_/_ BY � <br /> � <br /> _/ <br /> PROJECT ADDRESS(f known) <br /> Arisch four(4)copia of plans lor p'oposed work-Draw to xale end rwM ths folbwhig M applkable: � <br /> 'Property Lh�es 'Outlina and dimensbns of all exhting and propoeed structures on the bt 'Existing and proposed uti�kies O <br /> `CenlMine of Mreet 'lndicate Nath •Show arry proposed preding chengas 5how measurert�enta <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspection shall be made 24 hours in advance-phone 259-8810. O <br /> 2.All work shall be performed in accordance with this pertnit and curtent City of Everett Design and <br /> Construction Standards and Speciflcations. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-4246555. � <br /> V� <br /> �UOLIC WORKS �ERM�"• O <br /> h0 REUU�RE� a <br /> 4Y.�_.l_�q <br /> ��TE. __._�.�./..IY�� <br /> 1 <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> � The undersiyned ownm/applicant hemby agrees to ho�d and aeve hartnless <br /> the City ot Everett hom any and all elalms for damages,eosts,eapenses,or <br /> Approvetl for Construction Date �auses o}adion thet may arise beeause of Installetlon end meintenarka of <br /> the improvement orother rigMof-way ux hereto applied tor and hirther apsee <br /> to removc aame upon notice from the City end to replaee pubNc propsity <br /> damaged tMieby. <br /> FINAL INSPECTIOY Date <br /> ApPmved as Construcled <br /> Signetura ol Applicant Dete <br /> WORK AUhIORIZED BY THIS PERMR MUST BE STARTED WfTHIN iB0 DAYS OF DATE PERMR IS ISSUED AND THEREAFTER IS TO BE DILI(iENTLY PURSUED TO <br /> COMPLE110N.7HIS PERMIT MAY BE CANCELLED BY THE CRY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />