Laserfiche WebLink
---- ---- ---- - ---- — - .__ --- <br /> � : . r . . ., s��+• , , ; . _ ;,� .: ' <br /> Date '�31/90 � �� Pubi¢Wo�ks Pe�mi1. <br /> . Application For emy.neP�..QII�1,5�74 <br /> Pli�!IC WORKS PERMIT PublicWo�ksFee <br /> Ta�r�Fea $ <br /> Less ApPI.Fee Paitl $ <br /> Print or Type Only Balance Due s <br /> Fami7.y Ontlr.al c n a _ I <br /> Owner Mai{ing Address City Zip Phone � <br /> Northwest Oommercial Impzrnrements, Inc. 1252A 35th Ave SE Everett 9�208 337-5686 <br /> Applicant Mailing Address City �ip Phone <br /> Describe Proposed Work Tenant Imp=oVement <br /> W <br /> Project Address(if known) 5108 Evernreen Hsv � <br /> Attach four(4)copies of plans(or proposed wnrk- Draw to scale and note the following as applicable; � <br /> • Property Lines � • Centerline ot street � <br /> • Outline and dimensions of all existing and • Indicate North <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and pr000sed utilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE � <br /> I PERMITCONDITIONS <br /> t.All calls tor inspection shall be made 24 hrs.in advance-phone 259•8810. � <br /> 2.All work shall be peAormed in accordance with this permit and current Cily of Everett Design and Construction <br /> Standards and Specifications. <br /> 3.Call Loca!fon Underground Service 48 hrs.betore you dig.TOLL FREE NUMBER 1•SOG-424•5555. � <br /> �v/l.� LJc.:. '� :r.u7` /�/o!� /'�.-�� :.��� O <br /> � .�'` r ' � y// / � <br /> ��-�L.�!I/�^G^'1��y1- <br /> /L � <br /> � � fC <br /> O <br /> a <br /> ACKNOWLEDGEMENTOFCONDITIONS � <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br /> — less the City of Everett Irom any and all claims for dama9es, costs, <br /> expenses, or causes of action thal may arise because ot installation <br /> and maintenance of the improvement or other right-of-way vse hereto <br /> applied for and fur�her agrees lo remove same upon notice from ihe <br /> Approved tor Construction Date Cily and to replace public property damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Consiructed Signature of ApplicaN Date <br /> everett PUBLICwORKSDEPARTMENT W�RK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> � 3200 Cedar Street BE DILIGENTLY PURSUED TO CO?4PLETION. THIS PERMIT MAY BE <br /> Everett,WA 98201 CANCELLED BY THE CITY UPON AN�f STOPPAGE OF WORK ON THIS <br /> Phone:2F9-BB70 PROJECT OVER 90 DAYS DUR.4TION. <br /> I <br /> I <br /> � <br /> I. <br />