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�� c <br /> '" qpplication For Da�`_ <br /> �'UBLIC WORKS PERiMIT <br /> Public Works Permit R <br /> PUBLIC 1NORKS DEPARTMENT <br /> 3200 Cedar Street <br /> Everett, WA 98201 (425)257-8810 Bulldfng Per�nit k _ <br /> TYPE OR PRINT ONLY Public Worka Fee$ __ <br /> Owner Plan Chtck Not H 62864 SBPA Phone <br /> rpplicat.Dat�: 06/25 99 <br /> 3ob AddrQ��: 47b2 R6RESN WAY <br /> ��. Ownets E6PR6860 CONNECTION phona <br /> AAP� Tanants <br /> Propoead Use: ESPR68S0 STAND <br /> Do�c. of Work� � f 1 <br /> D2SCfibB PfOpOSBd WOfk_ F:XTERIOR AENOVATION ��� <br /> OFP'ICE SST JOB SET � <br /> � <br /> APPHOVED FOR P6RMITs DATB_/_/_ BY ♦^ <br /> V♦ <br /> PROJECTADDRESS (if known) �++ <br /> Attach faur(4)copies plans for propo^,ed work-Draw to s:ale and note the tollowing if applicabin: O <br /> �Property Lines •Outline end dimens�ons of all existln5�and proposed structures on the lat •Existing and proposed utilities � <br /> •Centerline of street •Indicate North •Show any proposed grading changes •Show measurements <br /> DO iVOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: Q <br /> 1. All calls for inspection shall be made 24 hours in advance - phone (425) 257-8810 <br /> 2. All work shall be pPrormed in accordance with this perm�i and current City cf Everett Design and � <br /> Construction Standards and Specifications., <br /> 3. Call Location Underground Service 48 tirs. before you dig.TOLL FREE NUMBER 1-BOa424-5555. ♦A <br /> V♦ <br /> O <br /> ?UOLIC WORKS PERM�"� a <br /> NOT UUTAE� <br /> � <br /> tY--- �-1- - /�--- <br /> �ATE.�.- I-I�=1_ .�.. <br /> ACKNOWLEDGEMENT OF CONDRIONS <br /> The underslgnetl owner/applicant hereby agrees to hold and save hartNess <br /> ihe Ciry of Evemtt from any end all claims for dameges,cosLa,expenses,or <br /> pprove or s �cuon a e causes of actlon that may arise because of installatlon and malntenence of the <br /> improvement or other righ4of-w2y use hereto epplled for end Iurther agrees to <br /> remove sama upon noUce from the Ciry ar.d to replace putrlb properry dam- <br /> aged thereby. <br /> FINAL INSPECTI0�1 Date <br /> Appmved es Constructed <br /> igna re o pp ican e <br /> WOFK AUTFIOFl�D BY?HIS PERNR MUST BE STARTED WITHIN 1FlU DAYS GF DAT�PERi.111'IS ISSUED AND TIIERFJ�FiER IS 7D BE DRJGENiLY PURSUED il� <br /> �LEf10N.TF1ISPERMRMAYBECANCEUEDBYTFECfiYUPONANYSSiOPPA(iE OFNIOFtICON71'iISPRQECTOVER90DAYSDUWUION. <br />