10303 19TH AVE SE 2016-01-01 MF Import

_ 1 _ I �8te/�/� puElicWorkeParm!;t � Application Fot eiav.oeai• .��/Y � PUBLIC WORKS PERMIT Pu�ToulFee`°° : � - Lese Appt Fea PaiU �U a� Balanca Due S Print or Type Only RICHARD A JOHNSON & CO INC 950^ - 19TH AVE S E SUITE C EVERETT WA 337-4830 Owner MaiNng Address City Zip Phone SA."II: AS OWNER Applicant Mailing Address City Zip Phone r Describe Prop:.sed Work STREET ST�JRM DRAINAGE. �ANITARY SEWL+R AND WATER II�ROVEMENTS IN CONJUNCTION WITH CONSTRUCTION OF 2 PRIVATE MEDICAL/PROFESSIONAL OFFICE BUILDINGS. g�-Dra#1 = 10303 - 1971+ A a� ��*z = i o30 - �� W ProjectAddress�ifknown� �02ND ST. S.E. L K � Atlach four(4) copies ot plans for proposed wo�k• Draw to scale and note the following as applicable: � � Property Linas • Centedine oi street � • Outline and dimensions ot all existing and • Indicate North proposed atructurea on the lot • Show any propased grading changes • Existing and proposed utilities • Show measurements � �� DO NOT WRITE BELOW THIS LINE � RERMIT CONUITIONS O 1.All calls for Inapectlon shell be mede 24 hrs.in edvence-phone 259-8810. � 2.All work shell be peAormed in eccordance with this permit end current City of Everett Deaign and Conatruction .itenderda end Speciflcetiona. 3.Call Locatlon Underground Service 48 hre.before you dig TOLL FREE NUMBER 1-800�4245555. � �. ��r �,o�ov-cc� �/ir— ,3-� -9 Z O f � � � O a � �� .1°��'�" ACKNOWLED�NT Oh,QQ�ITIONS,.••';�� i The undersigned owner/aDPlica�ereb�'a^grees tp�h411� �ve harm- less the City ot Everelt from any and all clni�A�,fffr�� ea coats, �� expenses, or causes of ection that may• ' 'd��e,Q�u4e af installation �� and maintenance of the improvement�o�t AgTi[of•wey use hereto ��`' � �` applied tor and turther agrees to remove��e upon notice from the Appr Cons cliu� ete CitY and to rePlace Public ProPerlY damaged thereby. s ?'z ��G�/c,n.�_._._ 3-G -9� FI L INSPECTION �� Date �c—� ApproveJ as Constructed Signature of Applicant Dete � PUBLICWOIiKSDEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE 3TARTED WITHIN 180 DAYS OF DATE PERMIT IS ISS•UED AND THEREAFTER IS TO 3200Cedar:itreet BE DILIGENTLY PURSUED TO COMPLETION.THIS PER�.�iT MAY BE Everett,WA 9�9201 CANCELLED BY THE CITV UPON ANY STOPPAGE OF WORK ON TNIS Phone:25gB�910 PROJECT OVER 90 DAYS DURATIOM.