620 58TH PL SE 2016-01-01 MF Import

Date r.bbc Wena Par Aprihcabon Foo Bldg Saint •, PUBLIC WORKS PERMIT e•b.et�rksFee f — Las•April Fee No f Print or Type Only Salon,.D., f 270!2 Owner Mailing Address City -/ �^� Y ZiP Phone Applicant Meiling Address Cd — -- Y Zip Phone Describe Proposed Work Project Address lit known) 11) �a p — T '="s pj XE' _ LU Attach four(4)copies of plans for proposed work•Draw to scale and note the following as applicable: • Property Lines •Centedine of street • Outline and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed grading change, • Existing and proposed utilities 0 Show measurements DO NOT WRITE BELOW ;:,IS LINE Im PERMIT CONDITIONS O 1. All calls for inspection shall be made 24 hrs. in advance-phone 259.8815. 2. All work shall be performed In accordance with this permit and cu,rent City of Everett Design and Construction 7 Standards and Specifications 3. Call Location Underground Service 48 hrs.before you dig. TOLL FREE NUMBER 1-800-424-5555. Z O O a ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/appllcant hereby agrees to hold and save harm- less the City of Everett from any and all claims for damages, costs. / expenses, or causes of action that rally arise because of installatibn �'eafyt- Gam`s�6 and maintenance of the Improvement or other right-of-way use hereto Approved for Con ruction applied for and further agrees to remove same upon notice from the Date City and to replace public propertydarrijiged thereby. �FINA INSPECTION Date Approved as Constructed Signature of Applicant TA13ate everett PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 3200 Cedar Street 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO Everett,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE Phone:259.8815 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.