Laserfiche WebLink
r <br /> Date�/�� �' Publl[Worke Permii+ �� <br /> Application For eie9.000c. <br /> PUBI_I� WURKS PERMIT P°�roialFeareB S s�3 <br /> � �esa noa�Fee aaie S <br /> BalencoDue S_� <br /> Print or Type Only - <br /> �£�- '�6a SG? <br /> T`-n.Q.� ��,.�..�r � I � �:n���.,, C� . ��uuti:��,, �;A. <br /> Owner Mailing Address City Zip Phcne <br /> SR.�.-.-.<-- <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work ���`ST�7�-L s�/�/�l/�j�` �G����G�- <br /> 0 <br /> o / � / � <br /> Prolecl Address(if known� � L� �� � �_���"���� � <br /> �$'uvTi7�o f- OU�yT �-W• uL�'T o/� CJ„ <br /> Attach four(4) copies of plans(or prcposed work• Draw to scale and note lhe fol ing as applicable: ��� � <br /> • Property Lines • CenleNine of 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 propos^d utilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1. All calls for inspeclion shall be made 24 hrs. In advance- phone 259-881 5. � <br /> 2. All work shall be pertorm d in accordance with this permit and current City of Everett Design and Consiruct�on <br /> Standards nd Specific ions. <br /> 3. Call Lo �n Urfdsrgr/ nd S�vi ce 48 hrs. before you d' :TOLL FR�-,fylJve/,�P 1• 0•424•5555. � <br /> y/� " S6f C <br /> �l /�.e�,9iJC�c c.7/i/� /�'�i�� �Li?/+I.S' <br /> �iaT�4 �� 'o2�1-r��� <br /> O <br /> . CU7tl/1�Z G'j IrIN / Ec� c.�/GG C�C � <br /> S ��v�`-�� � — �G_`��/!•'�T— �i��C/�� � <br /> . ��y/l B��r /!% �y�C /lY/✓��- O <br /> 6 s��.e E„�����.,�-- ���-� �/�` �`• �-'� p„ <br /> ��� .—f/ ST. cS_ cJ_ /�i5'i� ,PGr�' �.��o,e �2 ,�j'cc��i�R�c <br /> r <br /> oF c�-�sT��`���vry ' ACKNOWLEDGEMEMTOFCONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br /> less the City of Everett from any and all claims for damages, costs, <br /> � expenses, or causes of action that may arise because of installation <br /> / _/V �� ana maintenance M the improvement or other righFohway use hereto <br /> _f applied for and furiher agrees to remove same upon notice irom ihe <br /> Appro d for Cons ctig Date Ciry and to replace public property damaged thereby. <br /> ` c�(z� 1 � <br /> fINAL iNSPECTION Dale ���� �"'� � a' ( $ y <br /> Approved as Constructed Sign ::raei D p^'icant Date <br /> everett PUBLIC WOHKS DEPARTMENT WORK AUTHORIZED BY THIS PcRMiT MUST BE STARTED WITHIN <br /> 180 DAYS OF DATE PERMIT IS ISSI'ED AND 7HEREAFTER IS TO <br /> � 3200 Cedar Street BE DILIGENTLY PIIRSUED TO COMPLETION. TIIIS PERMIT MAY BE <br /> Everett,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone: 259-881 S PROJECT OVER 90 DAYS DUFATION. <br />