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Date S/3/95 <br /> n� 1 Papbc Wo�h�Pvmll• <br /> Applicatlon For � �y em� o•oi•_ Gp9L•7 <br /> PUBLIC WORKS PERMIT ��,lp PaDIKWorM���� <br /> .o�.�F.. • <br /> ln��oo�Po a•�a • <br /> Print or Type Only a.�.��.o�. � <br /> BOEING CO PO BOX 3707 M S OH-13 SEATTLE 98124 <br /> Owner MaillnpAdtlresa Cily 2ip Phone <br /> LEONARD 266-3563 <br /> Appllcent Meiling qddress C��y Z�U <br /> Phone <br /> Deecribe Proposed Work 400SF ADDITION TO F RF P ti�ip HOIISE <br /> Pro�ectAdaresa(Ilknown) app7 �� recrmn cn 5_ � <br /> Attech four(4)copiea ol plana for propoaed work•Draw to aeale and note Ihe lollowing ea appliceble: � <br /> • Property Lines � Centerline of etreel <br /> � Outline and dimensions of all e�istinp end • Indicafe North � <br /> propoeed struCturea on the lot • Show any proposed gradinp changee <br /> • Exlating end proposed utllitiea • Show meaeurementa <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS O <br /> 1.All cella for Inspectbn ahell be mede 24 hre.in advence•phone 259•8810. <br /> 2.All work ehell be peAo�mad In eccordance with thle permit end current City af Everett Deelgn entl Conetructlon � <br /> Sfandarde end Speclficatlona <br /> 3.Call Location Underpround Service 4B hra before you dlg.TOLL FREE NUMBER 1•800�424•5555. <br /> � <br /> � <br /> � <br /> � <br /> �'UBLIC WORKS PER411T O <br /> hOf tiEOUIpE� <br /> tAT--�T���_)_�_ - � <br /> '� � <br /> / ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner�applicenl hereby Bpreea to hold and save herm� <br /> less Ihe City of Everett from eny antl all clelms for tlemepes, coels <br /> expenses, or causes of ectlon thet mey erise becauae ol inetellation <br /> end maintenence ol the improvement or other right•of�wey use hereto <br /> Approved lor Construction epplied lor and lurther ag�ees lo remove sama upon notice Irom Ihe <br /> Date City and lo replace public p�operty damaged fheraby. <br /> FINAL INSPECTION Defe <br /> Approved aa Conalructed Signelure of Applicant Dela <br /> PUBLIC WORKS DEPARTMENT WORK AUtHORIIED BY THIS PERMIT MUSf BE STARTE� WITHIN <br /> 3200Ceder5lreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everet4 WA9B201 BE DIL�3ENTLY PURSUED TO COMPLETION. THIS PERMIT MAY�BE <br /> Phone:25B•8810 I �A!�CELLED BY THE CITV UPON ANY S70PPAGE OF WORK ON THIS <br /> PROJECT ObER 90 DAVS DURATION. <br />