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�aw�,F« � � � <br /> � PUBLIC MIORKS PERMIT Date z-z-98 <br /> PUBLIC WORKS DEPARTMENT Public Works PennN M �1J �� <br /> 3200 Cedar Street <br /> Everetl,WA 98201 259-8810 Building Pertnit N��789 <br /> TYPE OF PRINT ONLY "� Qr�STING �F� Public Worlcs Fee E� <br /> Kvernmo Construction 16212 Bothell Hwy SE Mill. Creek 98012 425 485-4911 <br /> Owner Maiiing Address City Zip Phone <br /> pwner phone <br /> Applicant Mailing Address ���Y Z�P <br /> Describe Proposed Work new house — Basic 1264 � <br /> . � <br /> q 98121 � <br /> - �7't�--^^ ' � <br /> 9 �n <br /> 4315 Creacent Ave Lot 4�{ ,_#`31-9q,B1`` � <br /> PROJECT ADDRESS(if known) - <br /> iGTA� 40.OU <br /> Atlach tour(4)copies of plans tor pmposed work-Draw to scale and note the following M appl'cable: f,_,���` �U <br /> •Prcperty Lines 'Outline and dimensions of all existing and proposed structures on the lot �Exist�n9 8^d Pr°Po��Oi15891 <br /> 'Centerline of street •Indicate North 5how any proposed 9rading changes 5how meesurements � <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: <br /> 1.All calls for inspection shall be made 24 hours in advance-phone 259-8810. O <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design and <br /> Construction Standards and Specifications. � <br /> 3. Call Locatioii Underground Service 48 hrs. betore you dig. TOLL FREE NUMBER 1-800-424-5666• <br /> � ��n i s p,c.r��� ?s �� s , �S w�' k �� 6� li'}ir.s o� 1.�,� — N <br /> ' ,�.�,{ � � ��1 T 7 S i G C w i�� b f, �SrJ U P.� O <br /> �� a.= ���,y�' a <br /> v✓1�� �.'he. G;{y� hT,�s ✓`C c i CJ�c� p�lq W�ow � �vr '{.�-e <br /> I r� <br /> r,c.g�; � �;►�c ti�d� �'. vl � 1 I <br /> f/� l � �1'�D�M� r+�CJrIG S �FK 5C. i�S�—�.�C � 'Cr�ti 5?�GiS�[GLi0v1 <br /> �` def;�H c��-c <br /> L4eo-�- -�'!-e �.�. co�.-cGl^ S�y i wetv';vu.� Gv. �,.J�;v►� <br /> � <br /> p�;�ru,•� . <br /> ACKNOW LEDGEMENT OF CONDITIONS <br /> The undersig�ed ownedepplicant hereCy aprees 10 hold and save harmless <br /> _ '�`—/ s the City ot Everett 6om a�y a�..all claims for dama9es,costs,expenses,a <br /> v � causes ol action that may arise because ol Iratellation and mainte�ance o� <br /> A � N ate theimprovementaMl�xrlght-o�-wayuseheietoappliedtorandturtfbreprees <br /> to remove same upon notice from the City end to replace pubiic propeiry <br /> . <br /> > of ./ •S- damag Ihereby. <br /> FINAL INSPE ON Date _ <br /> Approved as Constructed . �� <br /> Ct'�— <br /> Signeture of Applkant Date <br /> COMPLETION.RfH SD ERMIT MAY BE CANCE BLEDTBY THE CITY IUPON AN SOTOPPAG OFMWORK ONUTH�S PRQIECT OVER 90 DAYS pUMT10N.Y PURSUED TO <br />