8008 SPOKANE DR 2016-01-01 MF Import

Date Ppplica�ion For PUBLIC WORKS PERMIT Print or Type Only 1'uui¢ WOAe Pmmi� • oiaa 000�. � — PuObc W ake Fee Tol�l Fee s LefcAppl leaPeW s Oolenca Dua i l��r�.rA � Ay�,e 80��8 SPc�+ti� � a��,e��Y w�.sH y�'�o� 3s3 -G6a3 Owner Madin� Address Clty Zip Phone SH+,�r.� Applicant Mailing Address Describe Proposed Work Y3cIFLU N'�W �a/" Ptolec� Address (il known) City Zip Phone Attach four (4) copias of plens lor proposed work - Jraw to scale and note ihe following as applicable: • Proparty Lines • Centerline of street � Outline and dimansions ol ail ezistin9 and • Intlicate North proposed structures on ihe lot • Show any proposed grading changes • Existing and proposed utili�ies • Show measuremenis Approvedfor PERMIT CONDITIONS 1. All calls fm Inspection shall be made 24 hrs. in advance - phone 259•8815. 2. All work shall be pedormed in accordance with this permit and current City of [verett Design and Construction Standards and Specilications. 3. Call Location Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1•800•424•5555. PUBI/L L�JC>,eLS �.ef�,y ypT ,P��c�ieE'O Date FINAL INSPECTION Date Approved as Consiructed everet� PUBLIC WORKS DEPARTMENT � 3200 Cedar Street Everetl, WA 98201 Phone: 259�F3815 /-�2- B i �� ACKNOWLEDGEMENT OF CONDITIONS W H � � O � � O a The undersic�neA ewner/applicant hereby agrees lo hold and save harm- less the Gty of Everett Irom any antl all claims tor damages, costs, expenses, or causes of action ihat may arise because ol installation and mainte,nance ot ihe improvement or other right-ol•way use hereto applied lor and further agrees to remove same upon notice from �he City and to eplace public pr�o`pe�rty damaged theieby. /�� -.� ,�� Signature ol Applicant Date WORK AUTHORIZED BV THIS PERNIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT �S ISSUED ANO THEREAFTER IS TO BE DILIGENTLY PU(�SUED TO COMPLETION. THIS PERMIT MAY BE C�NCEL.L[D BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.