713 60TH ST SW 2016-01-01 MF Import

D �' NtecWeer Pe ale Beep.Dept Application For PUBLIC WORKS PERMIT p°°TI:"Fee s Lost app[Fee Paid • �— Btlence Dw $ �Q O Print or Type Only ho C)fffhl� -_ - =Q- � �w.e( r a/ Melling Address City Zip Phone �e�/,� Applicant Mailing Address OIl7 Zip Phone i Describe Proposed Work _ '-• �- -- W Project Address lit known) 7/.3 0 Attach lour(4)copies of plans for propos d work- Draw to scale and note the following as applicable: • Property Linea • Centerline of street • Outline and dimensions of all existing and • Indicate North proposed structure, on the lot • Show any proeosod grading changes • Existing and propcsed utilities • Show measurements M DO NOT WRIIE BELOW THIS LINF PERMIT CONDITIONS 1. All cells for inspection shall be made 24 hes. In advance-phone 259.8815. �\ 2. All work shell be performed in accordance with this permit and current City of Everett Design and Construction J Standards and Specifications. 3. Call Location Underground Service 48 hrs,before you dig.TOLL FREE NUMBER 1-800.424.5555. D.Q/✓EW1�5/ G f^td-Curs A�P� Aver 7D A' C.�2 two VA-00 O a ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harm- less the Citi of Everett from any and all claims for damages, costs, .P�,"�•ievdQ ✓�� uYt � expenses, or causes of act on that may arise because of installation /O B8 ani maintenance of the Impro ioment or other right-of-way u is hereto applied for and further agrees to remo-re same upon notice ihim the Approved for ruetl / Date City and to replace publpropvry dsmayed thereby. - Dale FINALNSPECTION r ' Me Approved as Constructed III nature of pp can WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED V/1THIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER 16 TO3200 Cedar Street BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE Everett,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS eve,r•It PUBLIC WORKS DEPARTMENT Phone: 259.8815 PROJECT OVER 90 DAYS DURATION.