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ApPlication For � ' <br /> � PUBLIC WORKS PERMIT Date 3-12-97 <br /> PUBLIC WORKS DEPARTMENT � Public Works Permil N 7 ��� <br /> 3200 Cedar Sireel � <br /> Everett,WA 98201 259-8810 8uilding Permit k 54512 ' <br /> TO POSTING �'�-9—' = s � � � '- <br /> TYPE OR PRINT ONLY � � �q��lorks Fee$ Z� <br /> N M � <br /> � M <br /> Ernest Moore 1032 E Marine View Dr Everett 9820�; 259-1583 <br /> Owner Mailing Address City � Ig2 y Phone <br /> 1� <br /> Owner � � �' � � <br /> Appllcant Mailing Address City � Zip Phone <br /> Describe Proposed Work carport w/shed � <br /> � <br /> � <br /> �// <br /> PROJECT ADDRESS(if known) 1032 E Marine View Dr � <br /> Adach tour(4)copies of plans for proposed work-Draw to scale and note the foilowing if applicable: O <br /> •Property Lines 'Outline end dimenslons of all existing and proposed structures on the lot •Existing and proposed utilities <br /> `Centerline of sireet •Indlcate North •Show any proposed grading changes •Show measurements � <br /> DO NOT WRITE BELOW THIS LINE � <br /> PEP.MIT CONDITIONS: <br /> 1.All calls for inspection shall be made 24 hours in advance- phone 259-8810. O <br /> 2. All work shall be pertormed in accordance with this permit and current City of Everett Design and <br /> Construction Standards and Specifications. <br /> 3. C�II Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> � Gr�e of a�c�� �o� fo �¢ ��Q�,yed, � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF COND'TIONS <br /> � The undersi9ned owner/applicant hereby agrees to hold and save hartnless <br /> � the Ciry ol Everett from any and all claims for damages,costs,expenses,or <br /> G� 2z v causes of action that may arise because of installation and maintenance of <br /> Approv forC strucf a�e theimprovementorothernghbof•wayuseheretoappliedforandfurtheragrees <br /> to remove same upon notice from the City and to replace public propeAy <br /> � / �7_ y-� damaged thereby. � <br /> C'T <br /> FI ALINSPEC ON Date {/- /�j/��/ 5� n� <br /> ApprovedasConstructed ��y.�lnA �• / " ' �/ � <br /> Signature of Applicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITFIIN 180 DAYS Of DATE PERMIT IS ISSUED AND THERFAFfER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOP('4GE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />