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� <br /> � APPlication For _ <br /> PUBLIC WORKS PERMIT �a1e 5-20-97 <br /> PUBLIC WORKS DEPARTMENT Pub�ic Works Pertnit k �� � <br /> 3200 Cedar Sireet <br /> Everetl,WA 98201 259•8810 Building Permit M 55203 <br /> TYPEORPRINTONLY �� �OSTING �UN 1 5 �� publicWorksFeeS ��� _ <br /> Hearthside Homes Inc 2911-1/2 Hewitt Ave 116 Everett 98201 303-9665 <br /> Owner Mailing Address City Zip Phone <br /> Owner <br /> Applicant Mailing Address City Zip 07��_� �PhQr1e_ <br /> 12P11 <br /> M 55203 <br /> Describe Proposed Work new home � <br /> PLU16IF6 84.00 � <br /> _ SUtCFIARGE 4.50 � <br /> PROJECTADDRESS(ifknown) _=0'L9 E Grand Ave Lots 1/2 � �K �'� <br /> Attach four(4)copies of plans lor pmposed work-Draw to scale and note the iollowing it applicable: Y�� �•� � <br /> •Property Lines 'Outline and dlmensions of all existing and proposad structures on the lot •Existing ecn�d p,�ropposed ut� O <br /> 'Centerline ot street •Indicate NoAh •Show any proposed gradirg changes •Show measurer�llrllS�" 70•� � <br /> DO NOT WRITE BELOW THIS LINE 12qb,pp <br /> PERMIT CONDITIONS: TOTAL 2972.70 <br /> 1.All calls for inspection shall be made 24 hours in advance-phone 259-8810. CHEK <br /> 2.All work shall be pertormed in accordance with this permit and current City of EveyttQ��yg and <br /> Construction Standards and Specifications. <br /> 3. Call Location Underyround Service 48 hrs. bafore you dig. TOLL FREE NUMBEFt 1-800-424-5555. � <br /> V♦ <br /> ! F:rep city strrcts cican at alI fitnrs. O <br /> �. Lisl,dl 5' wide sidew�ilk bzluud rzi;qug cwb ;wd gullrr a;pei siaudaizl plau !f30G un tlii, propeily'a lidl <br /> h�outagc � <br /> t�. Adlust w�ter aoxcs ro qade at cnd oFconsinichon. <br /> Rootlop c4:wiagc �h;�l bc discha�rrd lo ihc housc's sidc scwcr. <br /> ?. This housc shsll have a sinele sidesewcr connccNon to the cin sewcr main. <br /> ACKNOWLEDGEMENT JF CONDITIONS <br /> �^/:� •��/� The undersigned owner/applicant hereby agrees to hold and save hartnless <br /> y e the City of Everett from any and all clalms tor damages,costs,ezpenses,or <br /> F'ti�� � causes of action that may anse because of installation and maintenance ot <br /> ApprovedforConstructio Date theimprovementorotherright-ol-wayuseheretoappliedforandiurtheragrees <br /> to remove same upon notice hom the Ciry and to replace pubiic property <br /> 3..�r.� da lhereby. <br /> FINAL NSPECTION Date <br /> Approved as Constructed � // <br /> " 6 <br /> S na of Applican� �a <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DA7E PERA7IT:S ISSUED AND 7HEREAFfER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />