228 DORN AVE 2016-01-01 MF Import

TYPE OR PRINT ONLY Apptication For PUBLiC VUORKS PERMIT PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everetl, WA 98201 259-8810 TO POSTING � 1 e'ss� / Date 10-22-96 Public Works Pertnit p ��gZ3 Building Permit a 53302 Public Works Fee S ��} Loren Dorrah 2820 B Lincoln [,'ay Lynnwood 98036 787-6700 Owner Mailing Address City Zip Phone Curt Johnson 337-4733 Applicant Mailing Address City Zip Phone Describe Proposed Work _ new kenx- PROJECT AG�RESS (if known) 228 Dorn Ave Lot 7 SP 1127-95 Atlach fuur (4) cop:es of plans tor proposecl work - Draw to scale and note the .ollowing if applicable: •Property Lines `Outline antl dimensions of atl existing and proposed shuctures on the lot •Exsting and ptdp'ABd9filit�:l2liPS •Center6ne ot street •Indiwte North •fihow any proposed grading changes •Show measurements / UU NU I WHI I t BELOW THIS LINE ELEC 5210.00 PERMI7 CONDITIONS: Np0053'a02 1. All calls for inspection shall be made 24 hours in advance - phone 259-3810. ELDG 41?55.00 2. All work shall be performed in accordance with this permit and current City of Epte�tt Desgr�ptr� Construction Standards and Specifications. MECH 3:20.00 ?. Call Lo;ation Underground Service 48 hrs. before you dig. TOLL FREE NUMB�¢F�00-4?�,5C�5. DF.IVW�' �`O,DO t4D0009'.Bl 1. Keep city strcels clean at ;dl times. WRTEF 4750.� `. Cwb guller ;wJ sidew;tlF: W(IIC �)IJI ar� new ;wJ uud,una±�cd. ;wy d�uia�;e II��!i'be ep � ced al tl disereeion oF�t�e r��blic ��orks [nspec�or. W $�•� t�. Am chan ee in the diivewnv cut must be approved by the PW Inspectoc S�'SDEV 47.834. �l . Adjusl w�alcr boxcs lo �adc ai end ofconstruction. BNDIII 4725.W �' Dm�eways shall be com�ktety curcd before d�i�vic on Ihem. CHECf: 55044.50 i�. Side sewer and Stomi sewer conncetions shall bc iusiallcd a: p:r thc appro��ed cousrniction pi:m f'or the hort pl�t i�npro��cm�nl�. W H - � ♦�A V♦ O a ACKNOWLEOGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harmless the City of Everett fmm any and all claims. for damages, costs, expenses, or causes of action that may arise because of instaltation and maintenance of the Improvement or other right-of-way use hereto applied for and further agrees to remove same upon notice from th:e City and to re�iace pu6lic property damaged thereby. / l'%i��YN�"V� l/�'�lfl� �' I/ '� Signature f!� plicant Dale WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 780 DAYS OF DATE PERMIT �S ISSUED AND THFREAFTER IS TO 8E DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURAT70N.