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h <br /> ° r <br /> _� <br /> I • <br /> Date 10/1/91 a�ee�wo�k�ae�mn• _ I <br /> �"` 91/27652 <br /> . e�ep.0eo�.• � <br /> ' qpplicalion ror � <br /> PUBLIC WORKS PERMIT Pu�TowFeeFee S � <br /> Lea AOD�Fee ParE S ' <br /> 1� POSTING Baianro0ue S <br /> Print or Type Only - <br /> ��� <br /> H Stewart Ross 1301 Grand Av 252-4964 <br /> ��H Owner Mailing Address City Zip Phone <br /> 9 H t/� <br /> H � R�ckey & Work Const Inc. 2021 Lombard Everett, WA 98201 252-1311 <br /> ��� Mailing Address Cily Zip Phone <br /> Applicant <br /> H�1 <br /> oxo <br /> � C~/�r�i DescribeProposedWork Construct 9' X 6' closet addition to SFR <br /> H <br /> � Z <br /> o� _' <br /> H <br /> � �g LL <br /> c�• � � <br /> � y� Pro�ectAddress�ilknown) 1301 Grand Ave. <br /> r� N y Attach lour(41 copies of plans for proposed work•Draw to scale antl note the lollowing as apPlicable: s <br /> ���yyy • Property Lines • Centerline of sireet <br /> Oy M • Outline and dimensions of all existing and • indicate North <br /> C, d y proposed structures on the lot • Show any proposed grading changes � <br /> � �� • Existing and proPosed utili�ies • Show measuremenl5 � <br /> y p� DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS � <br /> 1.All calls for inspection shall be made 24 hrs.in advance•phone 259•8810. <br /> 2.AI�work shall be perlormed In accordance with this permit and current City of Everett Design and Construction � <br /> Standerds and Specificationa <br /> � 3.Call Location Und=rpround Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800•424•5555. — <br /> L <br /> C�� . z i.; ,- : f 2��r ,c;��>�«,_:./' � <br /> /�� /e,z. ��� �-�.. : . <br /> _ ` <br /> � � <br /> � ! ;c z %i � <br /> �� � C <br /> r ' � <br /> '�'� <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> � The undersigned owner/apPlicant hereby agrees to holtl and save harm <br /> �'� less ihe Ciry ol Everett Irom any and all claims for damages, cost, <br /> expenses, or causes ot aclion that may arise because ol installatio� <br /> and mainlenance ol the improvement or olher righ4ol•way use hereU <br /> � applied lor and luriher agrees to remove same upon notice Irom ihe <br /> �'� Approved for Construclion �a�e Cily and to replace public property damaged Ihereby. <br /> � I FINAL INSPECTION Dale Oate <br /> qpproved as Consiructed Signalure ol ApPlicant <br /> WORK AUTHOF12ED BY THIS PERMIT MUST BE STARTED WITHIt <br /> �Ar� PUBLICWORKSDEPARTMENT iB0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TC <br /> �200 Ceder Street BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY �C <br /> Everet4 WA 98201 CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THI: <br /> Phone:259•BB10 PROJECT OVER 90 DAYS DURATION. <br />