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Date 5jl^, _��pF <br /> P����� ����� publicWorksPermitN - � �'�=��`'-�'-'1 � <br /> PER M 1 T euilding Permit a <br /> PUBLIC WORKS�EPARTMENT planning Reterence N <br /> 3200 Cedar Street <br /> Everett,WA98201 � _ �- c � � <br /> Tp ) PublicWorksfee5 ;],:]�?_ <._ n <br /> (425�575�}Q^�-��R17 fCU � 1 2�09 G e5� �.� <br /> � I ��Q-�C_ ��.sC.� <br /> OWNER NAME APPLICANT NAIdE <br /> ANDADDRESS: iiL'U L:=':'1��.�5 ANDADDRESS JFtiiJu__ f:jC;[�, _f!' ?(' <br /> 4�32 17E '."':- <br /> �ELTTLE -: �.:,r, <br /> PHONE: PHONE: <br /> TARPARCELI.D.# PROJECTADDRESS: � , .,, - ,, r�-, GI <br /> DESCRIPTION OF . _ - ., � <br /> PFOPOSED WORK: - ._ __._ _ ._ . . . _ ._�.. . _ . . <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection shall be made 24 hours in advance. <br /> 2. All work shall be performed in accordance wilh ihis pennit and current City ol Everett Design and Consiruction <br /> Slandards and Specificalions. �� t <br /> 3. Call Localion Underground Service 48 hrs. before you dig.TOLL FREE NUMBER 1-800-424-5555 Y■1 <br /> � <br /> . _,i.". - _ "_ '.:mI. � <br /> . . t .. . _ _... . __.._.. -.� i_i��. Y/ <br /> r�--- i �r r— o '-^� W <br /> --�r-'�a���. O <br /> [Jrz•T - <br /> /� x �--� <br /> 1 � � !Tl ITl TI '1 v�`Tl <br /> C ,V '. � ���GlqS t . �vt1 k�t '-X .-. c$, = q � <br /> i <br /> � 3 �( D r �V � ' ' '-;`-; Z <br /> > �"l?l- 2 r t:7 � :`„ <br /> � ' O <br /> � <br /> '= rn..�.<n �.�,, -' �/� <br /> .. .h, � -- `�_ .L =' T V� <br /> '..l"J� f'�]f`.J rL��.i+] ` <br /> / :��{�.{�L.t�!U rJ�—' N <br /> :in1�Y,•f�Caf'a�N� -� O <br /> �.i <br /> �;= a <br /> � t� <br /> ------- — ACKNOWLEDGEMENT OF CONDITIONS <br /> . -�.— The undersigned ownedapplicant hereby agrees to holtl and <br /> t, ./i� ��3 ����� save harmless Ihe City of Everelt irom any antl all claims for <br /> �� G J I damages,costs,expenses,or causes ot action that may arise <br /> Appro� v e c l d r C o nstmc�ion Da�e because ol installation and maintenance of ihe improvement or <br /> �� '�� olher righl-obway use hereto applied(or and furiher agrees to <br /> �, _� /z_ z -C%, remove same u on notice from Ihe Cil and to re lace ublic <br /> r� / � P Y P P <br /> — � ly�� � �dy damaged Ihereby. <br /> FINAL INSP[CT N <br /> Appmved as Conslmcted Dato `n a�� ( . � / _ �_�� <br /> ;� �Wu �.Vli�l. L . <br /> _ Signawre of Applicant Date <br /> TJO COMPL[T�ION ED BYrLF1atE11AV BE CANCELLED 8V�HETCI Y�UPON AN�STOPPAGE QF WOFH ON THIS PROJEC OVER 90 DAVS DUR TTONPURSUED <br /> DAT40AR,INC. <br /> EPVJP Pd)6� <br />