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�P� <br />ro <br />y <br />b H N <br />. <br />y � <br />K �j <br />b M �V <br />N M <br />� N � <br />O H <br />N tn70 <br />L1 • f7 <br />s y � <br />� 1-I N <br />y <br />M <br />O fn <br />� ro trC <br />H O N <br />' �� <br />i <br />Date� <br />-v <br />Application F.,r <br />PUBLIC WORKS P�RMiT <br />Print or Type Only <br />9801 Dogwood Dr <br />M1lailing <br />Everntt 96203 <br />Pu�bc RbiFs Peimit � <br />eieaoeni.s 91/27099 <br />PUDLc \Yoi W Fea <br />lotal Fac $ <br />�ess aooi. rce ae�a 5 <br />u,��anroouc 5 <br />252-0568 <br />''-iP Phone <br />Snohomish 98290 568-8760 <br />Applicant Mailing qddiess Ci�Y Zi <br />p Phone <br />Describe Proposed work Add 3/9 bath in garage area <br />Project Add�ess �if known) <br />c <br />Attach four �4) copies of plans for proposed work - Draw to scale and note the tollaving as applicable; <br />• Properry Lines • Centerline of street <br />• OuUine and dimensions of all existing and • Indicate North <br />proposed structures on the lot • 8how an <br />• Existing nnd proposed utililies Y P�oposed grading changes <br />• Show measurements <br />PERMIT CONDITIONS <br />1. All c�lls for inspection shall be made 24 hrs. in ativance- phone 259•8810. <br />2. All work shall be pedormed in accordance with this permit and cuvent City of Everett Design and Construclion <br />Standords and Specifications. <br />3. Call Location Underground �ervice 48 hrs. before you dig. TOLL FREE NUANBEH 1-800-424•5555. <br />�.��fo <br /><<_c, lt�Oz/.:_ �/�-,�o�-z: �/'c7' <br />APpi�ved lor Conslruction Date <br />FINAL INSPECTION Dale <br />Approved as Construcled <br />�A��.� PUBLIC W07KS DEPARTMENT <br />3200 Cedar Sireel <br />Everclt, WA gB201 <br />Phonc:259�8�10 <br />� � <br />,� � i � L�'��I <br />�� i-��i <br />� <br />� <br />� <br />� <br />0 <br />a <br />i�CKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicanl hereby agrees to hold antl save harm� <br />less the City ol Everetl Irom any and all claims lor damages, costs. <br />expenses, or causes of action that may anse because ol installation <br />and maintenance of tlie improvement or other ric�hl-ol-way use hereto <br />applied for and lurlher ac�rees to remove same upon notice Irom Ihe <br />City and lo replace public property damaged Ihereby. <br />Sic�na�ure of Applicanl Date <br />WORK AUTHORIZED 8Y THIS PERMIT I,�UST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BE <br />C�NCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJ[C7 OV[Fi 90 DAYS DURATION. <br />