3430 COLBY AVE 2018-01-02 MF Import

Y Date 9 /r Public Works Permit# /( Application For Bldg.Dept.* PUBLIC WORKS PERMIT Public Works Fee Total Fee $ Less Appl.Fee Paid $ Balance Due $ J 0O Print or Type Only 002-322 - S10 -oOO-/7-83/ ��mm� ,p �y�� r�� 2L' ' O l ZS--� 12 J0- 06 3 30 `i/�y vCii siT is/!Ni i•, `k :\.. Owner Mailing Address City Zip Phone pplicant Mailing Address City Zip Phone Describe Proposed Work 17.7k La; p4 v t " , ow ertsrtia e 5) 6 PPOto--A. -1-2 ea. .V L_ of la Project Address(if known) 5.4i3 0 �u3 7 A-,/e-, v�� , u /8 ��I I— Attach four(4)copies of plans for proposed work- Draw to scale and note the following as applicable: • Property Lines • Centerline of street • Outline and dimensions of all existing and • Indicate North CO proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements DO NOT WRITE BELOW THIS LINE _ PERMIT CONDITIONS 0 1.All calls for inspection shall be made 24 hrs.in advance-phone 259-8810. 2.All work shall be performed in accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800-424-5555. 1/ 40466 z- � icad Sol _AU c Z6 cv.,' 1 0- co-eAeiti 0 o-zia II— ,: Co- d, ap�eJ �' ,8,7,, t ` � GCO dua�,� . _� az , Cozy ,:cn •rD, 0 ),pc_ ptiot) .z? etrue.1_, V ')-)/era - (& 3754 add, egi—ep_4.2, co2„pyz, - Cori-CAe 02 'ac' r Gd o/f% , iv a;t� 1 a�v d "I—2Z—7/ G'a / ara,=4 , ACKNOWLEDGEMENT OF CONDITIONS d The undersigned owner/applicant hereby agrees to hold and save harm less the City of Everett from any and all claims for damages, costs, >>> expenses, or causes of action that may arise because of installation 89/ and maintenance of the improvement or other right-of-way use hereto �� / applied for and further agrees to remove same upon notice from the Approved for Construction Date City and to replace public pro erty damaged thereby. FINAL INSPECTION Date CE N I!'-sf Approved as Constructed ignature of Applicant Date PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 3200 Cedar Street 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO• .74 Everett,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE Phone:259-8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.