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PUBLIC WORKS PERMIT Date: 10/21I2009 <br /> Public Works Permit #: PW0910-019 <br /> City of Everett Public Works Department <br /> �-,;�,��_ 3200 Cedar Street ' - - - � �::, Buildinp Permit #; 80910-014 <br /> Everett, VVA 98201 i ��� .: "`�planninp Reference#: <br /> (425) 257-8810 � ! <br /> �cl`li; ;,� ;i .: Public Works Fee $: $ 25.00 <br /> Other $: <br /> OWNER NAME AND ADDRESS: APPLICAfiT NAME AND ADDRESS: <br /> HUI TING FA ' � ' 'i" <br /> 1041813THAVEW i;�` , ��'� <br /> � <br /> _ ':i�"._ _.. �!'`.:� <br /> EVERETT WA 98204 q��;F�� __ �_i-, <br /> PHONE: 2068908890 PHONE: <br /> TAX PARCEL ID# 005523004D010 SITE ADDRESS: 10418 13TH AVE W <br /> DESCRIPTION OF PROPOSED Y"�^K: <br /> BEDROOM ADDITION <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 with the permit and current City of Everett Design and Construction Standards <br /> and Specifications. <br /> 3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 <br /> 4. The conlractor must meet with the Public Works Inspector, call Cliff Lindman at 425-339-7404, to discuss w <br /> potential drainage routing prior to beginning the project. <br /> � <br /> � <br /> � <br /> Q� <br /> � <br /> � <br /> z <br /> 0 <br /> � <br /> � <br /> 0 <br /> �, <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned ownedapplicanl hereby agrees to hold and <br /> save harmless the City o(Everett from any and all claims for <br /> /J damages, costs, expenses, or causes of adion that may arise <br /> �f ��(� !% because of installation and maintenance o(the improvemenl <br /> / �I"�d%��%%'�-'�'�--� JJ' , �7�_�� or other right-of-way use hereto applied for and (urther agrees <br /> A roved for Conslruction Date �o remo same upon notic��(rom the City and to replace <br /> PP public p perty damaged th eby. <br /> i <br /> --��i�,_�f"':�-�_.�� ----- - (G .� O . <br /> ,FIN,4�INSPECTION Date _ <br /> Approved as Constructed j c� l L' Signature of Applicant Date <br /> WORK AUTHORI2ED 6Y THIS PER�tIT MUST BE STARTED W[THIN I80 DAYS OF DATE PERh1IT IS ISSUED AND THEREAFfER IS TO BE DILIGENT'LY <br /> PURSUED TO COh1PLE7I0N. TNIS PERMIT h1AY BE CANCELLED BY THE CiTY UPON ANY STOPPAGE OF WORK ON THIS PROIECT OVER 90 DAYS DURAT70N. <br />