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Date / <br /> PUBLIC WORKS Public Works Permit# <br /> PERMIT Building Permit N <br /> CI;L77- PUBLIC WORKS DEPARTMENT <br /> 3200 Cedar Street Planning Reference a <br /> Everen,WA 98201 Public Works Fee$ <br /> (425)257.8810 <br /> Guarantee$ <br /> OWNER NAME APPLICANT NAME <br /> ANDADDRESS: ANDADDRLSS. 21507 7 <br /> l �:.an n q LYO( <br /> 1 i I OSTI NG.............".::............ <br /> PHONE: _ PHONE. <br /> TAX PARCEL 1.0.0 --- -- --- PROIECTADDRESS. - :TH FL SE <br /> DESCRIPTION OF <br /> PROPOSED WORK: - <br /> PERMIT CONDITIONS LJT 6, SID)?T FLAT <br /> 1. All All calls for Inspection shall be made 24 hours In advance. <br /> 2. All work shall be performed In accordance with this permit and current City of Everett Design and Construction <br /> Standards and Specifications. <br /> 3. Call Location Underground Service 48 his.before you dig.TOLL FREE NUMBER 1.800-424-5555 <br /> r <br /> W <br /> z <br /> 0 <br /> Iii— <br /> U) <br /> 0 <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> ! The undersigned ownor/applicant hereby agrees to hold and <br /> save harmless the City of Everett from any and all claims for <br /> App v Construction to damages,costs,expenses,or causes of action that may ansa <br /> because of Installation and maintenance of the improvement or <br /> ,} other right-of-way use hereto applied for and further agrees to <br /> r i �"j' C remove same upon notice from the City and to replace public <br /> FINAL INSPE N prOpanY damaged thereby. <br /> Approved a onelructed Is - <br /> __� X04 <br /> Spnewre of rcanl aro <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 190 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE 71LIOENTLY PURSUED <br /> TO COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br /> EPN?(heel DATABAR.INC. <br />