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-�� PUBLIC WORKS PERMIT Date: 10/23/2014 <br />�" Public Works Permit #: PW1410-024 <br />City of Everett Pub6c Works Depariment <br />�� ��,� ,: .;.-��. 3200 Cedar Slreet Building Permit #, C1410-004 <br />Everett, WA 98201 Planninq Reference �: <br />(425)257-8810 <br />Public Works Fee $: $ 20 00 <br />Olher $: <br />OWNER NAME AND ADDRE55: I APPIICANT NAtAE AND ADDRESS: <br />BLACKBURN PROPERTIES LLC <br />PO BOX 433 <br />SNONOMISH y�/q ggzg� <br />PHONE: 4252328733 <br />TAX PARCELID # 00497100004800 <br />DESCRIPTION OF PROPOSED WORK: <br />ROOF DRAIN CONNECTION <br />PHONE: <br />SITE ADDRESS: 2204 BTH ST <br />PEFMIT CONDITIONS <br />7 P.il calls (or inspechon shall be made 24 hours in advance <br />? PII work shall be performed in accordance with the permit and current Gty oF Everett Design and Construction S?andards <br />and Specifications <br />3 Call Location Underground Service 48 hrs before you dig TO�L FREE NUMB[R 811 <br />4 Connect roof drains per approved plan <br />FINAL INSPE <br />Approved as <br />Date <br />- Z� � <br />r-- �--- F—. � 1—� F—� I-� <br />" G: f.fJ T T—f: :T' T <br />j �_' i_ r. �_' F� r—' <br />__ c-� �. .r., c� ..� �� <br />C) � S G-1 <br />I • <br />A <br />Cl <br />J:� <br />��l <br />�.� <br />��� <br />�, � !�� <br />—�. s �tr l. � �r� (yi [�] � <br />y n r« <br />.L� - � � ,. <br />� _,� � �- <br />3, <br />G <br />l <br />C <br />ACKNO:NLEDGEtv7ENl Of= CONDI710NS <br />Thc undcrsigned ovmedappl�cant hereby agrees to hold and <br />save harmless the City of Everett from any and all claims lor <br />damages, costs, expenses. or causes of action that may anse <br />because of installation and mainlenance o( ihe improvement <br />or olher right-ol-way use herelo applied �or and further agrees <br />lo remove same upon noUce from the City and to replace <br />public property damaged therety <br />a� _ %U —ZS'— / �/ <br />� <br />Signature o( Appiican� <br />Date <br />VJORK AUTIiORIZED BY THIS PERhiR h1US7 8[ STARTED �7RHIN 180 DAYS OF DATE PERh1iT IS ISSUED AND THEREAFTER IS TO BE DIL(GENTLY <br />PURSUED TO COMPI.ETIOM. THIS PERI4IT h1AY BE UNCELLFU �Y TNC CITY UPON ANY STOPPAG[ OF WORK ON THIS PROJEf.-T OVER 90 DAYS DURAT10�1 � <br />I� uJ � �� <br />