11031 PAINE FIELD WAY 2016-01-01 MF Import

i � ��licalion For PUBLIC WORKS PERMIT Date_ 3-5-96 PUBLIC WORKS DEPARIMEM Pubiic Works PemN M �W 3200 Cedar Street E:verett,WA 98201 259-8810 BuilAing Pertnit N 51031 _ __ lYPE OR PRINT ONLY TO POSTI N G � � 9 �� Public Works Fee S � Theo Conetruction PO Box 2065 Bothell 98041-2065 206-486-7643 pwner Mailing Address CRy Zip Phone Ovner Ted or Diana Selin Applicant Mailing Address City Zip Phone Describe Proposed Work new house 01 17 � / • N00051031 BL.06 t5S6.20 � PL.813 i63.OD �/� IEdi f60.00 ��/ PROJECT ADDRESS(ifknown) Paine Field Wa Lot 1 S 94 � Atlachtour 4 �� ( )copies ot plans for proposed work-Draw to scale and note the tollowing H applicable: � � �.� O �Pro�ty Lirres `OWline anA dimensions of all ezisting and proposrJ structures on the lot •Eaisting and p�tl utilitiea__�,ro srss �Centerline ol street Nndicate North 'Show any proposea greding changes •Show measurements � DO NOT WRITE BELOW THIS LINE PERMIT CONDITIONS: Z 1.All calls for inspection shall be made?4 hours in advance- phone 259-8810. O 2.All work shall be performed in accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 7-800-424-b555. � � Roofler dr»nage �hall be dischnrged: � • "I'o the site's storm clrain syctem(private or puhlic) O • To a resiJenl�al ruuf'dowuspoul tiysre�u �le�iarird per seclion 4-9.4 of Ihv a city stcmdards . Onto splash hlocka 'I'he med�od selecled wsll Ue subject to Public �L'orkt Ln�pector approval. bF " — ACKNOWLEDGEMENTOFCONDITIONS „�A�� /� The undersigned owner/applicant hereby agrees to hold and save harmless /`/ the City of Everett from any and all claims for damages,cosls,eapenses,or Ap roved onslructlon Date causes ot action that may anse because of installation and maintenance ot the improvement or other rigM-of-way use hereto applied tor and further agrees .,w. � to remove upon notice from the City and to replace public property �� / �� damaged t reby. INAL 1NSPEC ate � Approved as Constructed � � G' '� V�+ Sign ture o p Date WORK AUTHORIZED BY TNIS PERMIT MUST BE STARTED WITHIN 180 DAl'S OF DA IT IS ISSUED AND THERFAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.