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Date 10/12/°'� '; � �,�"3/ <br /> YU POS1�iNG � - zs –95 ;,�,�,�,<<�,o,�=P�,m��. —`�-/ <br /> App�ication For r ��a� o�oi • 45823 <br /> PUBLIC WORKS PEROAIT P�tl�hc\VorFSFee - <br /> �t, iotrl Fee g <br /> f.:� <br /> Le554001 Fnnp.y.:t 5 <br /> l'l <br /> i,� c, r.:� o �_� o 0 <br /> P�ini Of TyPE Only 7 r i r� o c� r_� i.� � c� _h.}GZ,�,�o,�� S_ <br /> u_ <br /> C.I -+ i^ f] p O .l O l� V� p� <br /> n- . � r�i r.� r.i a+ r _., r..i .. <br /> ' � tJ -� � M M M �� C- �U <br /> .-1 ..i t^ n1� .. . <br /> John Faster 1123A 132nd St SE Evt ,.,982U'4�� 347-2678a p N <br /> Ownei \na�iiny qc:dress � nr--C�;�r ;t ii P�i ic Ei��-+ :� Phonc <br /> ,n Z� ci c� _ co > r. c� yi n �_' �.: <br /> .-i Gl G� O� Ll O �..� C: O �> Ul Cl W <br /> O _1 J W J Ci i� Cl ial .. _ <br /> r�i 't pl �i.. T {y� rt Ci �C UJ Ul "u] [., <br /> .v <br /> APPlitani ^Aai6nq Address --'— CiiY ZiP __--- Phone--�—---- <br /> a,���� <br /> Describe Proposed work ____NeG' 3ta�ee= Basic_281 _______ _ _ __ _ <br /> ------------ - --- -- W <br /> Proiect nddress(i� known� _ �Z21_GlenwonrLAve__�t± _ � <br /> ' �----- <br /> AttBCh fOW(4) COP�CS O� pl�ns foi prOPOSed wOrk - DrBv: Io .�:�ir, .�;•.il ni:ie ih�? 'oilu�ving as aPUlicable: � <br /> • Property Lines • Centerime of street � <br /> • Outlme and dlmensions of all ex�stmg and • I^tlicab� North <br /> proposeo c�rucWres on Ihe lot • �ho��.�any r.roposed yiatling c:�anges <br /> • Existing and proposed utilities • Shov+ measurements � <br /> DO NOT WRITE BELOYY iHIS LINE <br /> PERMIT CONDITIONS � <br /> 1.All calls tor inspection shall be matle 24 hrs.in advance•phone 259•881 U. � <br /> 2.All work shall be pertarmed in accordance with ihis permit and current City of Everett Design and Construction <br /> Standards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800-424•5555. � <br /> 4. Rooftop drainage shall be discharged: <br /> • To the site's stotm �irain systent (private or puUlic) O <br /> • To a resiilential roof downspout �ysteiu ilesigned per section 4- <br /> 9.4 of the city slanJards � <br /> • t�nto splash blocks � <br /> The meth�d selected will he subject to Public Works Departement O <br /> apgroval. <br /> a <br /> �,J ACKNOWLEDGEMENT OF CONDITIONS <br /> ' �1l/l.� <br /> �VI �i hr�.:��.der�a7ned owne�/applicant hcreby agrees to hold and sace harm- <br /> —�-�- ------� ioss thr Cdy of Gverett trom any and ali claims for dama9es. costs. <br /> /� /,�//////' //� � expenses. or causes ol action that may anss because of inslallation <br /> /� , j��r/ N Q — l� Z(f/� I and maintenance o! fhe �mprovement o� other nghbol-way use hereto <br /> �L /r� � ��� _ I ,a,^,plier: lOr and Iwiher ae�rces to remove same upon notiCe Irom the <br /> Approv d for Co truction ����' C��'v ar.r1 tn ieplace public property damaged thereby. <br /> _ � I <br /> �t'��� — T-8 -9� i ✓y�.� � <br /> FINAL INSPECTION Date i� /4*..e.tT�l. Lf�. �n. ��'�� � 9 <br /> Approved as Constructed I Sianat�ot Anphcan! Date <br /> PUBLICWORKSDEPARTMENT WORK AUTHOfl12ED BY THIS PERMIT MUST BE STARTEU WITHIN <br /> �A�'� 3200CedarStreet I 190 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,R'A98201 BE DILIGCNTLI' PURSUED TO COMPLETION. THIS PERMIT fdAY BE <br /> Phone:259•8810 C4NC[LLED BV THE CITY UPON ANY STOPPAGE OF VJORK ON THIS <br /> I PRO.IECT OVER 90 DAYS DURATION. <br />