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F�m¢wo�taaa�mn• --- <br /> Date�ll=9-1 � � <br /> e�ao oeo� • 91/27474 <br /> qpplicalion for - <br /> PuoLc Wor4s Gee <br /> p�JBLIC VNt)RKS PERMIT =o,e�Fea 5 <br /> LraaPoo� �aePa�d 5 <br /> � � � B.+�a�cr Our $ <br /> a Print or Type On!y <br /> D �1x <br /> 9Hf~i� <br /> t� Steven i'ierson 1?16 Hoyt Ave Cverett 98201 252-2549 <br /> H � � CdY ZiP Phonc <br /> y H Owner Ma��ling Atldress <br /> rC C� <br /> H �1 _ <br /> A�t H � Owner c��y La Phonc <br /> N y qpplicant Mailing Address <br /> HxE= <br /> � O �i Detached ltarage, 480 SF <br /> q H d Describe Pwposed Work <br /> H �g <br /> �� � � <br /> z9y� - <br /> r ~ y 171�i Hoyt Ave — � <br /> � Projecl Address(il known) <br /> H �� <br /> C�C[n 'A <br /> �p � AUach four(4)cop�es o�plans br proposed work- Draw to scalo and note Ihe tollowmg as�PPhcab c �� <br /> �� • CenlerlinF ol slreet <br /> • property Lines • Indicate Norih <br /> x y � • Outiine anA dimensions ol all exisling and � Sh�w 2�y��oposetl prading change; <br /> H O U1 pmposed strucWres on Ihe lol � �c,ryow mea5uremCn�S � <br /> �( ���...;;;��:��� ������������ • Exi5tin9 and prepused ulilitie5 <br /> f�� �O NO7 WRITE BELOK'THIS LINE ^ <br /> f `�� ti <br /> PERMIT CONDITIONS � <br /> � t.All calls for inspection shall be mado 24 hrs.in admnce�phone 259•8810. <br /> � �� 2.Ali work shall be pedormed in accordance with Ihis permit and curtent City of Everett Des�gn and Conslruction <br /> 1 Standards antl Specilications. � <br /> � 3.Call Location Underground Seraice 48 hre.belore you dig.TOLL FREE NUMBER 1•800•424•5 • <br /> � � � ,�� � t i � � <br /> �� � /�,/, � . � - - /' . . . , , �- <br /> I � � <br /> �. <br /> � ;,�-. <br /> , - V♦ <br /> b O <br /> ��t�� a. <br /> I�Do ACNNOWL[JGEMENT OF CONDITIONS <br /> '� The undersi9ned ownedaPP��'caN heieby a9�ecs�o hold and save ha���' <br /> Iess the Gily of Everett irorn any and all claims �or damages, costs. <br /> �� eapenses, or causes o� activ� that may arise because ol installalion <br /> and mainlennnce ol Ihe imprcvement oi other n9hPobwaY' ��se hereto <br /> applied lor and furlher agrees lo remove same upon notice irom ihe <br /> Approved for Construr,von Date Ci�y and lo rep�ace public prope iry tlama9ed IherebY. <br /> FINAL INSPECTION Date � Oate <br /> Signature ol ApP�icant <br /> qpproved as Conslructed WORK AUTHORIZED BY THIS PEAMIT �dUST 6E STARTED WITHIN <br /> � PUBLICWORKSDEPARTMENT 180 DAYS OF DATE PERMIT IS ISSU[D AND THEREAFTER IS TO <br /> 3200 Cedar Slreet BE DILIGENTLI' PURSUED TO COA'PLETION.THIS PERMIT MAY BP <br /> Everelt.WA98201 CANCELLED B�THE CITY UPON AN�STOPPAGI:O�WOf7K O�J Tl��i�' <br /> Phone'.259�8010 PR0.IECT OVER 90 DAYS OURATIOtJ <br />