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� szes <br /> ., <br /> ApP6cationFor 8/:'.�9: ' <br /> � PUBLIC 'dVORKS PERIVIIT Date _�_ <br /> PJDLIC WORKS DEPARTMENT public Works Permit M ,.___�_L,[�1�p_ <br /> 3200 Cedar Street u� � <br /> Everett,WA 98201 259-8810 Building Permi�M = 56290 <br /> '� PQST�NG °�T----- <br /> IYPE OR PRINT QNLY p op 0 0 .y oub�V�orgs�F�ee� <br /> �O� N� O O IfJ 0 +-i O I/7 O O M O M M <br /> C�CJ • 47 • �fjV Q • tAy�Q. O <br /> PAUL BUSTARD CONSTRUCTION PO BOX 120�� � ��ERES�TP Q,��PR)e Q; ��3lsqC65�617i _ <br /> Owner Maiiing Address City Zip "'� �`�Phor� <br /> � <br /> r <br /> N J � -r � �l W �y"'� � � <br /> YJ <br /> Applicant MailingAddress i � � �-+ ip � � W oPhone <br /> oamry� � � � a �avi � aswf" <br /> Describe Proposed Work NEW HOUSE - BASIC 1243 . G , <br /> W <br /> --�- � <br /> � <br /> PROJECT ADDRESS(if;cnown) ✓4Ls'l ��Gt�t't�l LOT 2 SHORT PLAT 8-95 � <br /> Attach four(4)copies of plan:>for proposed work-Draw to scale and note the following it applicable: �A <br /> •Property Lines 'Outlin=and dimension,01 all existing and p�oposed structures on the lot •Existing and proposed utilities �[ 1 <br /> •Centenine of street •Indicate North •Show any proposed grading changes •Show measuremenis wl� <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: � <br /> 1. All calls for inspection shall be made 24 hours in advance- phone 259-8810. O <br /> 2.All work shall be performed in accordance with this pertnit and curcent City of Everett Design and <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> � , � v��.�I �n d;v;�u� I ��2�/ e� w�t�cr �.�c.L �o lx�se, O <br /> � cv� � z s �`��` `� �� ;.� <br /> � . P��,�d� �,�5,� � - a <br /> � <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> ,„/�� /' _ ��� The undersigned ownedapplicant hercby agrees to hold and save hartnless <br /> �/�'� `'�Q�t— -�i�7 the City of Everetl from any and all clair s for damages,cosis,expenses,or <br /> Ap ove�ruction Date '�—� �auses of adion ihat may arise becaise of insta�lation and maintenance ol <br /> the improvement or other right-of-way use hereto applied for and further agrees <br /> to remove snme upon notice from the City and to replace pubiic property <br /> a _a j -S� danaged t� by. <br /> FINAL INSPECTION Date — <br /> Approved as Cocstructcd <br /> ,,ignature of lican e <br /> WOnK AUTHORIZED BY THIS PERA7IT MUST BE STARTED WITHIN 180 DAYS OF DAlE PERMIT IS ISSUED AND TNEREAFfER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLEiION.THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANV STOPPAGE OF WORK ON THIS PR0.IECT OVER 90 DAYS DURATION. <br />