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�` /� <br /> '` [� p(� 9�z/ <br /> ��=94 TOu POSTING • � l��ir P"bi�cWo�xePnrmit� _L <br /> � /�� Application For � eiag oeui • �5434 <br /> � PUBLIC WORKS PE�iMIT �'�'��'�W�H'6Fee -- <br /> Ta�ri c�e s— <br /> p LeSi�ou� Fnn Paia S �� • <br /> p 1� u� g � 8 g eaia��e o�c 3 � . <br /> Print or Type Only °% n <br /> � N � � � � �3ZZs�o//83/ <br /> M N � M <br /> HD SIEFFERT CO 2320 N <br /> Owner Ada�lin�.-; AC�ress m � �t � �n Phone <br /> EVERETT DOWNTOWN STORAGE � � � � � � �' � - — <br /> Applicant Mailinq Address C�i�� Zip Phone <br /> Describe Proposed Work �0 STORY ADDITION _____ _____ <br /> -- ---------- --- W <br /> Project Address lit knownl Z320 NEi1ITT AVE ___________ � <br /> AttaCh four(4)copies of plans fa Proposed work � Dra�n�tn�cei��ano ncte �he toilowiny as apUhcable: � <br /> • Property Lines • Centeriine nl street � <br /> �� • Outline and dimensions ol all existing anA • Indicate North <br /> � � � proposed structures on ihe lot • Shrnv any r.ronosed c�ratling chanyes <br /> � , • Existing and proposed utilities • Show measurements � <br /> � � � DO NOT WRITE BELOW THIS UNE � <br /> ' PERMITCONDITIONS O <br /> � 7.All GII�for Inspection shell be mede 24 hrs.in edvance•phone 259•8810. � <br /> � ? 2.All work shall be pe�formed in eccordence with this permit and current City of Everett Design and Conatruction <br /> ' i 3tendards�nd Specificetions. <br /> � � i 3.Call Lacetion Underpround Service 48 hrs,belore you dig.TOLL FNEE NUMBER 1•BOO-424-SS55. � <br /> � `(/p� d�j Si� �v �2 c�in� P¢r PLo.�.r O <br /> QPProvC o�o•� ��9t�. /Co�vf/ 4��l�eC�,> � <br /> � <br /> � <br /> O <br /> a <br /> ACKNOWLEDGCMENT OF COkDITIONS <br /> The undar�,aned owner/apphcant hereby agrees to hold and save harm� <br /> ---- --`—i iess Ihe Cny ot Everett Irom any and all claims for damages. costs. <br /> � expenses. or causes ol action that may arise beCause ot inslallalion <br /> � � anA mamtPnanr,e o! Ihe improvement or other ngh�-of�way use here�o <br /> appl�r.0 for and turiher agrees to remove same upon notice Irom the <br /> Approved for Cons on a��' I G!y and tn replace pub6c properry damaged Ihereby. <br /> � <br /> �� I �-% �-'� 9/2ff��i <br /> FINAI INSPECTION Date � <br /> Approvea as Constructed Sianature ot A n��can! Date <br /> � PUBLICWORKSDEPARTMENT \NORK AU7HORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> tA0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200CederStreet BE DILIGENiLY PURSUED TO Ct�MPLETION. TNIS PERMIT MAV BE <br /> Evetetl,WA9B201 � CANCELLtD BY THE GTY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259-8810 � PROJECT OVFR 90 DAYS DURATION. <br />