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i <br /> � ��' <br /> H <br /> Q N <br /> ��HGfn <br /> H5� � <br /> / <br /> �H� ro p � - ,-�-a- z 3 — <br /> N H O�� PuCuc lvmk?Paimn• <br /> i3 Date 7 1�_Q� / �I oiae Deo� • 37422 <br /> �O � AnPlication For ��'-��� !���� <br /> yt' PERMIT � P��p��cWe�bFco $__ <br /> o H pU g L!C ro„�Fee <br /> � �� W O R K Lrsa nno� Fee Pa�a S-- <br /> �,. � o,�,�«o�� s 2U-- <br /> t"y� Prini or Type Only <br /> g�y Select Homes Inc 237 Elm St Everett ldA 98203 258-1508 <br /> n Cy g=g�zk�cgadasgatasxxxxxxSxx&�89xMa3nx8xaYxxxxxxx8pnkane�:mRxx88888sxxxx�888�P8�3 e���a� <br /> �� �� Mailing Adtlress <br /> �o� ,xa�asxg�c�xxxg�r.•^�X��xa«acaxac�cxt�t}Csa�a�x}Cx�x�ca� � <br /> CitY Zip Phone I � � <br /> Mailing Address 1 ^\ <br /> qpplicanl v' <br /> new house construction <br /> Describe Proposed Work <br /> W <br /> ���zZ pa��..��c--� �N• � <br /> Lot 20 �-- � <br /> Proiect Address(il knowN ��' � <br /> Altach loar(4)�opies c�P�ans lor proposed wo�k- Oraw lo scale and oole��e��1erline of Ipee�a61e� <br /> • property Lines • Indiwle Nor1h <br /> • Outline and dimensions o1 all exislmg and � Sh�w any p�oposed 9�ad�ng chenges � , <br /> proposed slructures on lhe lot • Show me�suremenis <br /> '��� • Existing and proposed utilihes <br /> ' I DO NOT WRITE BELOW THIS LINE O <br /> ■ <br /> 7 � <br /> PERMIT GONDITIONS none 259•8810. <br /> '�' 1.All calls br inspection shall be made 24 hrs.in advance•p <br /> ' ' 2.Alt xork shall be pedormed in accordance with ihis permil and current City ol Eve�ett Design and Constmcllon � <br /> Sta�dards and Specifications. pr c i t;� <br /> � 3.Call Location Underground Service 4B hrs.before you dig.TOLL FREE NUMBER 1-800•424•555 . <br /> 4. instal.l rodc construr_ti.on entranr_e br_hind dri.vewa�`1blir Worb:s o <br /> � l standard ;S�i�Ci and er-osion control a� direcled b% <br /> ' / Inspector. times <br /> �� g, Keep city streets �lran at all l�t �i_e new and undamaaed, � <br /> f—' 6. Curb qutter and sidewalk. in the P �� <br /> any damage theret.�c{o�ll be replaced at the discretion ofi the <br /> � F'ublic Works lnsp the F'W In- <br /> 7. AnY �hanUe in the drivelineclimited to e�isting apron width. O <br /> � specl-or, width at prop drains to storm drain <br /> � S. Connect all roof , /ard and dr'ivewa% � <br /> ' system provided ta lot. <br /> � 9. Fld7usi-. wate� bo::es to qrade atcendd�heforetd,rivi�ng•on the�n. <br /> �_' 16. Drivewav�= shall be completely <br /> ' ACKNOWLE�GEMENT OF CONDITIONS <br /> A�j The unders�g�ed o�vner/app�icant hereby agrees to hold and save harm- <br /> ^�� less ihe City ol Everell Irom any and a�� claims tor dama9es, costs. <br /> � / a^f yxpenses. or causes of aclioo lhat may arise because ol installalion <br /> J��� (/�), �,LG, /���Z and maintenance o( the impwvemenl or olher iigh4ol-way use hereto <br /> �/��Lwl.'�! - / aPPlied tor and further agrees ro remoa9ed herebyn notice trom ihe <br /> Dale City����/7�o�epla�je p lic prop�«Y� <br /> AP�roved br Constru��on �/��,C'/'� '�')i,�'J L�/ <br /> �i X�, L � � > <br /> \� 3 lr•5'3 +� �' •, <br /> ./`�C'�� � Date � � Dale <br /> FINAI INSPECTION 5�)n ture I APPlicant <br /> qpproved asConstructed �/�rORK AUTHORIZED BY THIS PERMIT MUST BE STARTED W�THIN <br /> PUBLIC WORKSDEPARTMENT BE DI�LIGE O LY�PURS ED TO'COMPLE�TION.DTHIS PERMIT MAY 8E <br /> �� 3200 Cedar Slree� GANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Everelt,WA98201 pROJEGT OVER 90 DAVS CURATION. <br /> Pho�¢259�8810 <br />