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� °� POSTING "ov 2 4 �► <br /> � APPlication For / . <br /> PUBLIC WORKS PERMIT Date z-z�-9, <br /> PUBLIC WORKS DEPARTMENT Public Works Permit q � / I <br /> 3200 Cedar Street <br /> � Evereri,WA 98201 259-8810 Building Permit p 54341 <br /> NPE OR PRINT ONLY Public Works Fee$ Z D <br /> JDH Construction �0604 Brown Rd Monroe 95272 794-5235 Jim Hard <br /> Owner Mailing Address City Zip Phone <br /> Owner � <br /> Applicant Mailing Address CiTy ZiF Fhone <br /> ,�-..�,r,:�,,., � _ �. . . _�C'r.:a��_: •::.. <br /> , Describe Proposed Work new house � � <br /> !f ' 5C`: <br /> � � ,,-• � <br /> :_, ,:� <br /> =_.;u ytie_-_�-� <br /> u`" ttii '!l —I � <br /> .v�...� <br /> J��rt:�(2 {i -�`: <br /> PROJECT ADDRESS(if known) 103 Forest � Lot 12 --''#�4iiiaker pt�-'• � <br /> :;°'_��?0�_^4^ <br /> Attach four(4)copios of pians for proposed work-Draw to scale antl note the following if applicable: -, _ � <br /> � O <br /> •Property IJnes 'Outline and dimensions of all ezisting and proposed structures on the lot •Existing and qq ed vY�Mies <br /> �.:.� <br /> 'Centedine of street •Indicate North •Show any proposed grading changes •Show measurements__,._,,: ;,` � <br /> DO NOT WRITE BELOW THIS LINE ;��,,:; _;;,i� ` � <br /> PERMIT CONDITIONS: - =� � <br /> 1.All calls for inspection shall be made 24 hours in advance- phone 259-8610. <br /> 2. All work shall be performed in accordance with this permit and current City of Everett Design and O <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREF NUMBER 1-800-424-5555. � <br /> 4. Keep city etreete clean at all times. � <br /> 5. Curb gutter nnd aidewalk in the plat ere ne�v and undsmaged, eny dsmege theret O <br /> �►hail be repiaced at the direretion of�he Public Worka Inrpector. A <br /> F• Anq change in the drlvewey cut muat be approved by the Public Worke Inepector, �� <br /> width at proN line limited to existiag apron width <br /> 7• Adjuat �vnter boxes to grade at end of construction. <br /> �s• Drivewxya rha[I be completely cured befare driving on them. <br /> g. Rooftop drainage shall be diecharged as foliowa: <br /> a) Lot�t 1 thru 10 ahall dlscharge to splaeh blocks or other aQproved device <br /> b� Lota 11 thru 18 ahail dlscharge lo the storm drain stub provided at the <br /> front of the lot. <br /> ��� <br /> : ACKNOWLEDGEMENT OF CONDITIONS ' <br /> � � The undersigned ownedapplicant hereby agrees to hold and save harmless <br /> the Ciry of Everett from any and all clalms for damages,costs,expenses,or <br /> Approved f � nstructio p 1e causes of action that may arise because 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 trom the City and to replace public property <br /> - /O- Z -97 damaged thereby. <br /> FINAL INSPECTION Date � <br /> Approved as Constructed <br /> � 3 Z -�' <br /> Si ureotApplicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUSi BE STARTED WITHIN 780 DAYS OF DATE ERMIT IS ISSUED AND THEREAFfER IS DILIGENTLV PURSUED TO <br /> COMPL�ZION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />