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. . � 8�'� - yso <br /> Date � �� � �uDlic Wo«a Parm�L�...Lr.,---/,��,--����/ <br /> Applicalion For ema oea�.•—=—�-f--�--� <br /> PUBLIC WORKS PERMIT °°°�KN�°,�,F.° s - <br /> iolal Fee <br /> , Ll63 R00��!9 Paid S � <br /> Print orType Only ae�.��ao�a s_ 0�0 _ <br /> JFM Const;.tiction 1231 South Dirnctor Street Seattle, WA 9810E3 <br /> Owner Mailing Address City Zip phone <br /> SaiflC <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work COnStiVCt F011r—Plc:3: �r� � <br /> .9_Bc o W <br /> �� <br /> Proiect nddress pt known� _ 6003 Broadv.•a Avenue EWerett � <br /> F,Itach four(4)copies ol plans for proposed work• Draw lo sCale and note the lollowing as applicable: � <br /> • Property Lines • Centerline of street � <br /> • Outline end dimensions of all ezisting and • Indicate Norlh <br /> proposed structures on the lot • Show any proposed gratling changes <br /> • Ezisting end proposed utilities • Show measuremenls � <br /> 00 NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDI7lONS <br /> 1. All calls lor inspection shall be made 24 hrs.in advance•phone 259•881 5. � <br /> 2. All work shell be pertormed in accordance with this permit and current City of Everett Deeign and Construction <br /> Standards and Specificetions. <br /> 3. Call Loca�ion Underground Se•vice 48 hrs. before you dig.TOLL FREE NUMBEH 1•800•424•5555. � <br /> O <br /> �w <br /> �E <br /> O <br /> O� <br /> ACKtJOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant here6y agrees to hcld and save harm- <br /> les� ihe Cily ol Everetl Irom any and all daims for damages. costs. <br /> ��� � � expenses, or cau5es ol action thal may arise because ot instaltation <br /> C �`% �� /��� p and mainlenance of lhe improvemenl or other rigP.t�ohway use liereto <br /> �l � apFlied tor and furiher agrees lo remove same uPon notice irom �he <br /> Approved lo 'cns;;u�.tion � Date Cit>�and to replace public properly damageA therzby. <br /> { � ��i`f �4�"l <br /> �'i�`y .�A�U lil/�/�'6 <br /> FINAL INSVcC?ION Date �•' <br /> Anpro:=G as Conslructed �ign ture cf Applicanl —l� Uefe <br /> everett� PUBLIC WORKS DEPARTMENT VJORK AUTHORIZED BY THIS PERMIT MUST BE STAFTED WITHIN <br /> � 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 Cedar Street BE DILIGENTLY PURSUED TO COMPLE?ION. THIS PERMIT MAY BE <br /> Everelt,WA 98201 CANCELLED BY THE CITY UPON ANY STUPPAGE OF WORK ON THIS <br /> Phone: 259-3815 .-.aataiECT OVER 90 DAYS DURATION. <br />