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929 PINE ST 2016-01-01 MF Import
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929 PINE ST 2016-01-01 MF Import
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Last modified
5/18/2017 1:27:10 PM
Creation date
2/24/2017 3:51:46 PM
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Template:
Address Document
Street Name
PINE ST
Street Number
929
Imported From Microfiche
Yes
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Date�C/�Lc�� <br />� • t <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />LZp.� T <br />Mailing Address <br />�� <br />� <br />Pu�lic Woihf Parmil • �/�— ��f <br />eiee� oao�� • �L <br />Pubbc Works Fce <br />Totel Fee s <br />Less PpP� Fae Peltl S ��J <br />Balanca Uue s y ✓ — <br />t 2i3 <br />2/5/ <br />Phone <br />�rz� zsz -z9 �b <br />� Phone <br />Describe Proposed Work _�LE.�g�QL�a -� ��r1,f(y��e/ — {t� .ss„ �= <br />_� <br />Prolect Address (il known) <br />Attach four (4) copies of plans tor proposed work - Draw to scale and note the following as applicable: <br />• Property Lines <br />• Outline and dimensions of all e;�isting antl <br />proposed structures on the lot <br />• Existing and proposed utilities <br />• Centerline of street <br />• Indicale North <br />• Show any proposed grading changes <br />• Show measur.:ments <br />PERMIT CONDITIONS <br />1. All calls for Inspection shall be made 24 hrs. in advance • phone 259-8810. <br />2. All work shall be Vertormed in accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. befoie you dig. TOLL FREE NUMBER 1•800-424-5555. <br />�..�'� �ro�- 8���a - <br />Approved br Conslructio� Date <br />� � -d 3 - d'7 <br />FINAL INSPECTION � ' Date <br />Approved as Consiructed <br />evere[t PUBLIC WORKS DEPARTMENT <br />� 3200 Cedar Sireel � <br />Everetl. WA 98201 <br />Phone:259-8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less Ihe City ot Eve�ett irom any and all ciaims for damages, costu <br />expenses, or causes ol action that may arise because ol instaltation <br />and maintenance ol the improvement or other righbohway use hereto <br />applied lor and further a es to remove same upon nutice from the <br />City and to replace pub�operty damaged thereby. <br />nature ot applicant Date <br />ORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHI�� <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />
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