8401 HOLLY DR 2018-01-02 MF Import

, Date,�'�^ D� P�o�,�wo,k��a�m��, `�3 /S Application For Bltlg.Depl,a PUBLIC WORKS PERMIT �VOTotelFeeFee $ �o. Qo Lass AppL Fee Pnitl � i Print or Type Only ea�a��eo� a O. o d \ �''t'0� t't\�Oc�. 'L � :: C�ro.�.� L��Mx-o.�. C�nvr c^� �Cv Q,Y�C `1�1A`� �S'� 1�S�, Owner !dailing Address City Zip Phone C Y'!�7�� `f�> ��O �V\t�� W Av. `V�?C�`� \ Yv •�7-0.y-'�� Appiican Mailing Address City Zip Phone . � Describe Proposed ork � \ � Y� \� '� \h �l"��r � � Project.4ddress(if known� � � �� 'T � r -- � I� Attach four(4) copies of plans fcr propcsed work• Draw to scale and note the tollowing as applicable: i� r� � Property Lir,es • Centerline of street I�f� �; • OuGine and dimensions of all existing and • Indicate �orth V� proposed structures on the lot • Show any proposed grading changes • Existing and proposed uti'�ities • Show measarements � DO NOT WRITE BELOW THIS LINE O PEFMIT CON�ITIONS 1. All calls for inspection ;hall be made 24 hrs. in advance- phone 259-881 5. � 2. All work shall be perfoimed in accordance with this permit and current City of Everett Design ard Construction Standards and Specifir.ations. 3. Call Location Undergr�und Service 48 hrs.before you dig.TOLL FREE NUMBER 1-500•424•5555. � �, Ma,��a, r 0. � o �o��- ".�" � �1� � re.e � _ b � � � O a'o vi • '�-�2 �O�,�.T�1 — w P 51 e r 1 Q �-o P C r� � 1 v� � 1 1 -� � 'o_ b.� -�(er b�-�„�, ee.� -�,e Pa,rce�� G.1�Q ♦�^ .�e :s� ,.� S�,e -�.,.,..: I..l l�o��.,e s �� c.c�,a.e e�,� P to� V♦ S. ,�_v.�t�a.�� 2ro`� ��c.� W ��ro I wl7P•'1 R.nJ� i� �P � �.t�2rc5C • O V�y `�1� 't C �.�o�\c. �JV�:,t7 ��.n9pPC�or' � \ � �s ACKNOWLEDGEMENT OF CONDITIONS The undersigned oviner/applicant hereGy agrees to hold and save ha�m- less the City of EvereU from any and all claims for damages, costs, --� .� � �—� expenses, or causes ol action that may arise because of ins�allation C �� and maintenance of the improvement or other right-of-way use: hereto applied tor and lurther agrees to remove same ��pon notice `�om the Ap ove ( on,tructi �ate City and io replace public prope d2mac�ed ihereby. � 1�� .cz� ��1��s_;- ��'�� FI INSPECTION ( Date �'�—. Approved as Constru �yr�utu f Applic t I)ate everett PUBLIC WORKS DEPARTMENT WORK AUTHORIZ BY THIS PERMIT MUST BE STARTEC VJITHIN � 3200CedarSire=t 180 DAYS OF DA PERMIT IS ISSUED AND THEREAFTER IS TO Everett,WA 98207 8E DILIGENT�Y PURSUED TO COMPLETION. THIS PERMIT MAY BE Phone: 259-8815 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK DN THIS PROJECT OVER 90 DAYS DURATION. .