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�� <br /> � ;� ::Qf�7 <br /> P��"� �0��� Date � � , <br /> �r1.rn�ng-nn_ <br /> Public Works Permit# <br /> P���'� Building Permit# <br /> PUBLIC WORKS DEPARTMENT � <br /> 3200 Cedar Street Planning Reference# <br /> Everett,WA 98201 Public Works Fee$ ''�`''�E; <br /> (425)257-8810 <br /> Guarantee$ <br /> OWNER NAME • -'— ' � _. APPLICANT NAME TTiF?NE3?S <br /> AND ADDRESS: ?�a�O H�1Y 9 9 STE E AND ADDRESS: T,,,,T u-,�Y,,�_,�-- <br /> 'L'1rI`lhTk�t?OD T,w?i. ��(1?r; <br /> ,-.�;,_,,-.�=i,_ <br /> PHONE: PHONE: "'`` "` ' ' <br /> TAXPARCELI.D.# " �- �''- � �— PROJECTADDRESS: -�'�'�� �''�'T�I�`i i`:� <br /> DESCRIPTION OF ' <br /> PROPOSED WORK: <br /> ��. T�('T�tT�F'_', {71T'T';.—r;F- r'rr.���, �:'.��r�-':TFi:i� A1�tr, `''Z'�t ..;'��_:t.'F'� <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection shall be made 24 hours in adva�ce. <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 4S hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555 <br /> �. �?3ti' l�Fr T .� L ^Tr, _'_ �,:_r?o;:it� �!::� t7 t r 1-'�- � � � <br /> • �3_}:, <br /> J. .E�'RI:.+ � L"::12_ _.� �f _�i �L+_�1" i3�'1AL'I: �; i�l1��F_i.3T -ir .J .�(i i a _I,�_s.l'd�l jlii:�,3:.,'r '�.1�^f a:7':, � . — • ' � <br /> �_�I7_'�;, � <br /> � <br /> O <br /> � <br /> � <br /> O <br /> � <br /> � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned ownedapplicant hereby agrees to hold and <br /> ���,�_ �� � �� 7 save harmless the City of Everett from any and all claims for <br /> �� � damages,costs,expenses,or causes of action that may arise <br /> oved for Construction D e because of installation and maintenance of the improvement or <br /> other right-of-way hereto applied for and further agrees to <br /> remove same up n notice from the City and to replace public <br /> FINAL INSPECTION propert a�nag d hereby. <br /> Approved as Constructed Date <br /> Si nature of Apphicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS C)F DATE PERMIT IS ISSUE D THEREAFTER IS TO BE DILIGENTLY 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 /> EPWP(7/06) DATABAR,INC. <br />