Laserfiche WebLink
NPE OR PRINT ONLY <br />� 1 plicatlon For <br />PUBLIC WORKS PERMI�' <br />PUBLIC WORKS DEPAR'fMENT <br />3200 C?dar Slreet <br />Everett,'NA 96201 259•8810 <br />J G Ev�,rett LLC 11400 SE 6th Bellevue 98004 <br />Owner Mailing Addreu C�.y <br />� <br />Date �/21/96 _ <br />Pu61ic Works �ermit # <br />Building Permit ri SQg3.3 <br />Publlc Works Fee $ <br />462-1515 <br />Phone <br />Kelly Moore Paints Gary Yaconetti 462—]515 <br />Applicant Malling Address Ciry Zip Phone ^� <br />Describe Proposed Work <br />PROJECT ADDRESS (if known) <br />T.I. <br />6220 Evergreen Wy <br />Attach tour (4) copies of plans tor proposed work - Oraw to scala and nole the following if appllcable: <br />•Property Lines •Outline and dimensions of all existing and proposed siructures on the lot •Exist�ng and proposed utilitles <br />•Centerline of street •Indicale Norih "Show any proposed grading changes •Show measurements <br />DO NOT WRITE BELOW THIS LINE <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in ade�ance - phone 259-8810. <br />2. All work shall be performed in accordance with this per;nit and current City of Everett Design and <br />� Construction Standards and Specifications. <br />qR� Call Location Underground Service 4E hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />... U%��C �°r�r 0-�✓n�; � <br />Approved tor Construction Date <br />FINAL INSPECT�ON Date <br />Approved as Consiructed <br />,���- ����;�� <br />�� <br />�-�-�� <br />W <br />F— <br />— <br />N <br />� <br />O <br />� <br />� <br />O <br />V♦ <br />O <br />a <br />ACKNOWLEDGEMEPIT OF CONDITIONS <br />The underslgned owner/appl!cant hereby agrees to hold and save harmless <br />the City of Everett from any and all clatms for damages, costs, expenses, or <br />causes of action that may arise 6ecause of Installation and maintenance of <br />the improvement or other right-of-way use hereto applied for and further agrees <br />to remove same upon notice from the City and to replace public property <br />damaged thereby. <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS � ERMIT MUST BE STARTED WITHIN 780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURSUED TO <br />COMPLEfION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON AfJY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS OURATION. <br />