12906 19TH AVE SE FRED MEYER FUELING STATION 2018-01-02 MF Import

PUBLIC WORKS PERMIT Date: 08 PWO81 Public Works Permit #: PW0810-005 " City of Everett Public Works Department Building Permit #; B0810-010 Cedar Street Everett, WA 98201 Planning Reference #: (425) 257-8810 Public Works Fee $: $ 1,215.00 Other $: OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: FRED MEYER STORES BARGHAUSEN, ROBERT MCNEIL 3800 SE 22ND AVE PORTLAND OR 97202 PHONE: 5037973509 PHONE: 4256561061 TAX PARCEL ID # 28053000406200 SITE ADDRESS: 12906 19TH AVE SE DESCRIPTION OF PROPOSED WORK: FUELING FACILITY FOR FRED MEYER PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hours in advance. 2. All work shall be performed in accordance with the 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 811 F- 4. Per Approved plans � Z• 23 • � 9 Approved for Construction Date r ,rM L INSPECTION Date o7 Approved as Constructed m CAI �i W o _O 'LTt O �1A L2. twNr�—o �y ey r. �•��ocn n Ulofi�'--goo �� •O --QI ACKNOWLEDGEMENT OF CONDITIONS The undersigned ownerlapplicant hereby agrees to hold and save harmless 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 property da ge be eb . /o Signal Ap Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 160 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY URATION. PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS D `Iv