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Appliwtlon For ` ��� f/ <br /> ���� F'UBLIC WORKS PERMIT Date 6-3-9� m/' <br /> PUBLIC WORKS DEPP.FlTMENT Public Works Permit# _���_�� <br /> 3200 Cedar Screet <br /> everen,wnsezu� zss-esio BuildingParmitN 55319 _ <br /> TU POSTI N 6 nFr 0 9 � public WorYs Fee$_�_' <br /> TYPE OR PRINT ONLY <br /> Phinney Construction PO Box 976 Everett WA 98206 475-337-6832 <br /> Rdigp[][];HY,YiUc$E(#[gX} �[KIcxS[88�%X7C�C8Y3i88X�EX�dCY <br /> Owner htailing Address City Zip Phone <br /> Or�mer <br /> Applicant Mailing Address Ciry Zip Phone <br /> Describe Proposed Work �e�i house � <br /> � <br /> 2221 (n <br /> PROJECT ADDRESS(if known) C ►}� <br /> i�1 <br /> Attach four(4)copies of plans tor proposed work-Draw to scale and note the following if applicable: O <br /> •Propedy Lines •Oulline and dimensions of all existing and proposed structures on the lot 'Existing and proposed Wilities <br /> •Centcrline of streel •Indicate No�h •Show any pmposed grz.ding changes •Show measurements � <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 /> f'�+nstruction Standards and Specifications. <br /> 3. Call L�cation Underground Service 48 hrs. before you dig. TOLL FREE lJUMBER 1-800-424-5555. � <br /> 10-17-97 8:41AM � <br /> q 55319 <br /> 6UILD 67^c.70 O <br /> FLUMB 7�.00 <br /> MECH 60.00 A <br /> SRCHG 4.50 fd� <br /> UitIVE 20.00 <br /> PLAN Cf; ll.12 <br /> q 9423 <br /> WATER 650.00 <br /> q 31153 <br /> SEWEF 70.00 <br /> UTILITY 1296.00 <br /> TOTAL 2861.32 <br /> CHEK c^861.3^c <br /> A OM25].3 <br /> .9� <br /> ACKNOWLEGGEMENT OF CONDITIONS <br /> ,�K /� /�� The undersigned owner/applicant hereby agrees to hold and save harmless <br /> 1" (Q ihe City of Everett from any and all claims for damages,wsis,expenses,or <br /> causes of action that may arise because of instulla!ion and maintenance of <br /> Appr vedlorCon wction pa�e lheim rovementorothernghbof-wayusehereloappliedforandfurtheragrees <br /> � /� to m ve same upon notic d to replace public property <br /> � ��,/(/ �y�� _ ,� .�6—s� maedthereby. <br /> �7"k <br /> FINAL INSPECTION Data � �— <br /> Approved as Constmcted �jJ' �` , Cj� <br /> _ ignaWre of Ap cant _ Date <br /> N,'ORK AUTHORIZED 8Y TNIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DAi E PER!v11T IS ISSUED AND THEREAFTER IS TO 8E DILIGENTLY PURSUED TO <br /> COMPLEfION.THIS PERMIT MAY BE CANGELLED BY THE CITY UPON ANY STOPPAGE Of N'ORK ON THIS PROJECT OVER 90 D�YS DURATION. <br />