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Date 8/3/94 <br />PUBLIC <br />Print or Type Only <br />v 3 �7 <br />Application For r <br />WORK_B231ERMIT <br />{pp <br />X <br />op o�POSTpIIHG <br />to f'Of In O IT r, <br />ell <br />r� . CJ Ifl C; <br />a, co co -i ar IF 1 I^ <br />M <br />M <br />.D y W a MID <br />no <br />WASHINGTON TECH EDUCATION ASSOC &0 BZ 972 La Conne <br />Qwnr,r \1alilny __ <br />S Porter <br />Applicant <br />Describe Proposed Work <br />Project Address (if known) <br />New house <br />i <br />Public Works Permit <br />Bldg. Door. • <br />Puhkg Works Fee <br />Total Fee $ <br />U �SsAppl Fee Pain $ <br />0 $ <br />O YCJ <br />M CJ OJ <br />N M <br />17 466-3952 <br />4cd n S •t6 JM nC, co = rZj. O h 00 13J uu,) 5 Yllane <br />Address — .--- —� ZIn Phone <br />4901 Fowler <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the ..Ilowing as applicable: <br />• Property Lees • Centerline of street <br />• Outline , dimensions of all existing and • Indicate North <br />proposed , ictures on the lot • Show any proposed grading changes <br />• Existing and proposed utilities a Show measurements <br />PERMIT CON DiTIONS <br />1. All calls for inspection shall be made 24 hrs. in advance - phone 259-8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. C:all Location Underground Service 48 his. before you dig. TOLL FREE NUMBER 1-800-424.5555. <br />4. Rooftop drainage shall be discharged: <br />1) to the site's storm drain system (private or public) <br />2) to a residential roof downspout system designed per section 4-9.4 of the city standards <br />3) onto splash blocks <br />The method selected will be subject to Public Works Departement approval. <br />W <br />H <br />z <br />O <br />ch <br />O <br />a <br />C1� ACKNOWLEDGEMENT OF CONDITIONS <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 />and maintenance of the improvement or other right-ol-way use hereto <br />11.•+c%___ __ applied for and further agrees to remove samo upon notice from the <br />Annrnue for ons�ruchoft�' I City and to replace public property damaged Inereby. <br />FINAL INSPECTION Date Dare <br />Appre•red as Constructed d8O <br />store of Apphcan! <br />RK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />PUBLIC WORKS DEPARTMENT DAYS OF DATE PERMIT IS ISSUED AND THEREAFTCR IS TO <br />3200 Cedar Street BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />Everett. WA 95201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WCRK ON THIS <br />Phone: 259.8810 1 PROJECT OVER 90 DAYS DURATION. <br />