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% <br /> 'pp"`au°"Fo` 1/19/99 <br /> PUBLIC WORKS PERMIT Date <br /> PUBLIC WORKS DEPAFiME'JT Public Work;Pertnit N ��/ - <br /> 3200 Cedar Sireet <br /> Everett,WA 98201 259•8810 Duiltling PermN N 61398 <br /> $ �!'li �J^ <br /> TYPEORPRINTONLY . � n�STING � E—� PubiicWorksFeeS. l�J� <br /> GARY JE>>•TSON PO BC!X 6241 LYNivW00D 98036 425-250-061�ono <br /> Owner Mailing Address C�tY Z�P <br /> ApPlicant Mailing Addre:s City Zip Phone � — <br /> Describe Proposed Work NEW HOUSE - BASIC 2022 W <br /> � <br /> _ . , � <br /> ,� _. .1, :t� �// <br /> eui�_�; .� .... <br /> PROJECT ADDRESS(if known) 5415 IIROADWAY /� <br /> W <br /> Attach four(4)copies of plans tor pmposed work-Draw to scale and note the following if appiicable: � O <br /> •Property IJnes 'Outline and dimensions of all existing and proposed slructures on the lol •Existing antl proposed utNtties. <br /> •Centerline of street •Indicate NoAh •Show any proposed 9rading changes `Show measurements � - � <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: <br /> 1.All caiis for inspection shall be made 24 hours in advance - phone 259-8810. O <br /> 2.All work shall be penormed in accordance with this pertn�t and current City of Everett Design and <br /> Construction Standards and Specif��,�tions. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555• H <br /> � <br /> y Roof 1op nmotl'<hould Uc disch�uSed to rool'ivnoiTiufillration �csicm� dcsiened and rnnslnictr O <br /> m �ccordAnce wilh city sl�uidards, ifthe soils on the eile � <br /> �. Drive���ys �uid private acce�s ro�ds should be desi,Sned ;u�d coustivcled to prevent Ihe c<�Ilection <br /> ofstonn waler. <br /> 6. IuGltration systems provided f'or rooitop �uid%or dricc��my nmofi'must be designed end localcd t <br /> ��aid negative imp�cts lo Ihe new lots ancl to acijacent properties, in��rticul:u�. 'llie potcnlial <br /> ;�drerse efTects ou existitia .wd propo�ed buildings su�d othcr stnictares must be co��eidered smd <br /> :i� oided. If intilti.�tion svslemv c:umol bc: locnfed to avoid potenlial adverse efTects, �n att,rn,iic <br /> tu�:Ihod of slorm w,�t�r di��:osal tnust hc providcd. <br /> 1 �,I�G. [Tvc.".. to ;:,�ure con���lianc� ���Ui thcii rce�wmendatiou�; tnu�l a�r��rove Ihe propo;�a�l <br /> n•yidciica•. <br /> ACKNOWLEDGEhiE�`1T OF CONDITIONS <br /> � /� The underslgned owner/app!�cant horeby agrees to hold and save harmless <br /> the City ol Everetl from any anA all cla�ms for damages,costs,expenses,a <br /> causes of action that may arise because of mstallatlon and maintenance ot <br /> Ap vedforCo ction �a�e 1helmprovementorotherrighl-of-wayuseheretoappliedforandfurtl�eragrees <br /> ' to remove same upon nolice from the CIry�and to replace publlc property <br /> � _/r_�-j'f damaged thereby. <br /> FIIdAL IN PECTON Date <br /> Approved as Constructed � <br /> Signature oi nt ate <br /> P <br /> COMPLETION.RTFIIS PERMIT MAY BE CANCELLED 8Y THE CINIUPON ANY S�TOPP GE OF WI ORK ON THIS PR EC OVER 90 A 3 WR4110N.Y PURSUED <br /> � <br />