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TYPE OR PRINT ONLY <br />policatlon For <br />PUBLIC `WORKS PERMIT Date <br />5/18/98 <br />PUBLIC WORKS DEPARTMENT Public Works Permit a <br />3200 Cedar Stram -- -- <br />Everett, WA 98201 259.8810 Building Permit a 58865 <br />Public Works Fee S <br />SFIEKER PROPERTIES 1150 114TH AVE SE BELLEVUE 98004 <br />Owner Mall,ng Address City Zip Phone <br />NORTHSHORE CHRISTIAN CHURCH CONTACT JAMES THOMAS 425-259-0661 <br />Applicant Melling Address City Zip Phone <br />Describe Proposed Work _ CHANGE OF <br />PROJECI ADDRESS (if known) _IS15 <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following If applicable: <br />'Property Lines 'Outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities <br />aCenlerline of street •Indicate North 'Show ary proposed grading changes •Show measurements <br />PERMIT CONDITIONS: <br />1. All calls for Inspection shall be made 24 hours in advance - phone 259-8810. <br />2. All work shall be performed in accordance with this penult and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />L� Ail <br />d1 \ <br />- ' 1 slue pre�ro�> <br />-- <br />aUDLIV YJORks PENpA;1 <br />Nit;/Y,�RGUWNE• <br />frATf s so pA ' <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />W <br />H <br />y <br />co <br />0 <br />z <br />0 <br />0 <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damages, costs, expenses, or <br />causes of action that may arise because of Installation and maintenance of <br />the Improvement or other right-of-way use hereto applied for and further agrees <br />to remove same upon notice from the City and to replace public property <br />damaged thereby. <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />