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Date: 4/29/2011 <br /> PUBLI�C iNORKS PERMIT public Works Permit#: PW1105-001 <br /> City of Everett Public Works Department guildinq Permit#; <br /> 3200 Cedar Street <br /> ��� Everett, WA 98201 Planning Reference#: <br /> (425) 257-881 o Public Works Fee$: � 45.00 <br /> Other �: <br /> APPLICANT NAME AND ADDRESS: <br /> OWNER NAME AND ADDRESS: <br /> COMPASS IIEALTH <br /> 4526 FEDERAL AVE#3810 <br /> EVERETT WA 98203 <br /> PHONE: <br /> PHONE: <br /> TAX PARCEL ID# 00439079500500 SITE ADDP.ESS: 3315 LOMBARD AVE <br /> DESCRIPTION OF PROPOSED WORK: <br /> FIRE DAMAGE/SPRINKLER SYSTEM CONNECTION <br /> 1 4�C <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection shall be made 24 hours in advance. <br /> 2. All work shall be performed in accordance with the permit and current City of Everett Design and Construction Standards <br /> and Specifications. <br /> 3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUh96ER 811 <br /> 4. Restoration of City facilities such as streets, curb &gutter and sidewalks shall be the responsibility of the � <br /> Compass Health contratoc (� <br /> 5. City streets are to be kept clean at all times � <br /> 6. Work on fire service outside ihe building to be done per plan approved on 512/11 t/] <br /> 7. Any damaged sidewalk or sidewalk in need of repair or repiacement must be accomplished with this project by q <br /> the owner. Consult with the Public Works inpector for details and field review. � <br /> � <br /> Your inspector is Randy Allen, 425-339-7403 � <br /> � <br /> N <br /> � <br /> � <br /> �=+ <br /> 1 <br /> TO POSTING s/ 1 7 / / � ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicanl hereby agrees to hold and <br /> save harmless the City of Everelt from any and all claims tor <br /> demages, cosls, expenses,or causes o(aclion ihal may arise <br /> because of installalion and mainlenance o(the improvement <br /> /% � or other righ4of-way use herelo applied for and further agrees <br /> �f��Ltc'y=— ��z�` �� lo remove same upon notice frem the Cily and to replace <br /> Appro fo[ oqstruc n� Date public property damaged lhereby. <br /> . <br /> � / <br /> �2✓i- ��. � ����- �`- c7�/��i < C,( / <br /> F AL INSPE ION Date ' <br /> Approved as Const�ucted _ Signature of Applicant Date <br /> 1YORK AUTHORIZED BY THIS PERh1IT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS]SSUED F,ND THEFEAFTER IS TO�E DILIGENTLY <br /> PURSU[D TO COf4VLEf70N. THIS PERt•1[T h1AY GE CANCELLED 8Y THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECi OVER 90 CAYS DURATION. <br />