517 PECKS DR 2016-01-01 MF Import

�3� � D ~ 5/26/93 Pu0licWork�Parm114 �3 B�Op.Dapt• AppllCation For PUBLIC WORKS PERMIT PueTot�FeeFas , Lass�oo�Fee PYia Z� ' � B�lanta Dua s Print or Type Only lielen Schwartz 517 Peck's Dr Everett 347-6189 Owner MeiNny,Address . Ciry Lp Phone r: Davis Const (Mike Davis) ' 652-6712 Applicant Mailing Address City Zip Phone Mother-in-law apt Describe Proposed Work W Pro�ect Address�it known) 517 PeCks Dr � Attach four(4)copies of plans for proposed work- Draw to scale and note the following as epplicable: � • PropertY Lines • Centerline ot street � • Outline and dimensions of all existing and • Indicate North proposed siructures on the lot • Show eny proposed grading chanpes • Exlating end proposed utilities • Show measurements M W DO NOT WRITE BELOW THIS LINE O PERMIT CONDITIONS �� 1.All calls for Inepectlon ehall be made 24 hra in advance-phone 259$810. � � 2.All work shell be peAormed in eccordance with this permit end curtent City of Evarett Design and Construction Standards end Speclficatlone. 3.Cell Location Underqround Service 4B hrs.t etore you dig.TOLL FREE NUMBER 1-800�4245555. � O , � � O a � ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and seve harm- Iess the City of Everett irom any and all cleims for demeBes, costs. C-'7�""_ � / eKpanses, or causes of action that maY arise becauae of installation �_ /'/�//9� and maintenance ot the i t or other right-ot-way use hereto � �� Y applied for and further a rees to rem sama upon notice irom the s Approved for Cbris ructia� Date City and to replace public roperty damage ereby. %l..i/�f� FINAL INSPECTION �a1e te Approved as Constructed Signature o pplicant WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN � PUBLIC WORKS DEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO 3200 Ceder Street BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE Everetl,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS Phone:259•8810 pROJECT OVER 90 DAYS DURATION.