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9/22/83 Pu01¢WodaPermp• �� �' <br /> Date eiec oeo�• 8 3/12 5 2 <br /> Applica:ion For / <br /> PubLc Wa�Ms Fee S� <br /> PUBLIC WORKS PERM�T TolalFee <br /> Lesc ApP�Fee PaIE S <br /> BaiancoUue S /=_ <br /> Print or Type Only ������7��3 <br /> Projects West Ltd. 10209 Sridgeport Way S.W. Tacoma <br /> 98499 582-6840 <br /> City Zip Phone <br /> Owner Mailing Address , <br /> Lti'�" <br /> Same phone <br /> APP��� Mailing Address <br /> Ciry Zip <br /> Single Family REsidence —�-- <br /> Describe Propos�:d Work <br /> W <br /> �.. M c I•' _ o� � � <br /> Proiect Address(il known) licable: <br /> Attach four(4)copies ol plans lor proposed work• Draw to scale and note�Cen�;erline o(sheet N <br /> • Property Lines • Indicate North <br /> • Oulline and dimensions of all existin� and � Show any propos^.d g�ading changes � <br /> proposed structures en the lot � Show measurements <br /> • Exisling and prop-sed uClities <br /> DO NOT WRITE BELO�"THIS LINE O, <br /> PERMIT CONDITIONS � <br /> 1, qll calls for inspection shall be made 24 hrs. in 2dvance- phone 259'681 6. <br /> 2. All work shall be perlormed in accordance with this permil and current City ot Everett Desi{�n and Construction � � <br /> Standerds and Speciticalions. � <br /> 3. Call Location Underground Service 48 hrs.before You dig.TOLL FREE NUMBER 1-300•424-555 . r <br /> .5TR�-�; /n'�''�rl/�-n'c'✓7a� s�2-� �/'.['..rr�� O �: <br /> � P�-,� ���� a-a9-�Y <br /> �"' <br /> � y � <br /> O C � <br /> a � � <br /> :� : <br /> �7 � <br /> r <br /> KZ :_. <br /> ACKNOWLEDGEMENT OF CONDITIONS �b- <br /> hcanl hereby agrees to hold and save harm- r ,: <br /> The undersigned owner/app' cosis, � �. <br /> less the City ol Everett from any and all claims tor damages, <br /> expenses, or causes ol action Ihat may arise because ot installalion O 4.' <br /> � �%� �� and � lenance ol ihe improvement or other righPof-way use her�tu <br /> ap e for and turther acJrees �o remove same upon notice irom lhe : <br /> tor C truction Date C' y d to re ce pu6lic prop rty ma .d ll�reby. � � - <br /> // ' <br /> Ap r � _ — <br /> _ �� , � � j� � �' <br /> , , , . <br /> ' Date t � ant Date � �_� <br /> FINAL I SPECTIO Si aWre ot APP� <br /> Approved as Constructed RY, AUTHORIZED BY THIS PERMIT MUST BE ST RTED WITHIN Z <br /> PUBLIC WORKS DEPARTMENT 180 DAYS OF DATE YERMIT IS ISSUED AND THEREAFTER IS TO y '1 <br /> everete BE DILJGENTLY PURSUED TO COMPLETION. THIS PERMIT NAY BE � <br /> � 3200 Cedar Slreet <br /> Everetl.WA 98201 CANCcLLED BY THE GTY UPON ANY STOPPAGE OF WORK ON THI <br /> Phone: 259�8815 PROJECT OVER 90 DAY:� DURATION. <br />