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� �)lication For <br /> PUBLIC WORKS PERMIT oa=e_ llibi9s <br /> PUBLIC WORKS DEPARTMENT Public Works Pertnit N <br /> 3200 Cedar Street <br /> Everett,WA 48201 259-8810 <br /> p Building Permit M��94LF <br /> TYPE OR PRINT ONLY TO f O STI N G `1' � �O public Works Fee$ <br /> LONG BOB 3001 HEWITT AVE EVERETT 98201 258-2591 <br /> a+'^� Mailing qddress City Zfp Phone <br /> TOWN 6 COUNTRY BLDGS — JESS HARRIS 800-824-9552 <br /> Applicant Mailing Address r�t <br /> Y Z�P Phone <br /> Describe Proposed Work STORAGE BLDG <br /> W <br /> N <br /> - <br /> PROJECTADDRESS(if known) �1"�A�E ZSCJ� ( Q S� _ � <br /> Attach four(4)copies of ptans for proposed work-Draw to scale and note tha following if applicable: � <br /> •Property LJnes �putline and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities O- <br /> 'CenterBne of street •Indicate North •Show any proposed grading changes •Show measurements <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspection shall be made 24 hours in advance-phone 259-8810. <br /> 2. All work shall be pe�fortned in accordance with this permit and current City of Everett Design and O <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> I � . <br /> ` ;1= U� <br /> � � '� a <br />' � �,,1'... ..' /, r <br /> ` �� ��% <br />� <br />� - �� <br />� ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save hartniess <br /> the City of Everett from any and all claims fur damages,costs,expenses,or <br />! A Date causes of action that may adse because of Insta�Iallon and maintenance of <br /> pproved lor Construction the impmvement or other right-of-way use hereto applied for and further agrees <br /> I'� to remove same upon notice from the City and to replace public pmperty <br />� damaged thereby. <br /> I FINAL INSPECTION Date <br /> Approved as Constrvcted <br /> Signature of Applicanl Cate <br /> WOFK AUTHORIZED BY THIS PERMIT A7UST BE STARTED WITHIN 180 DhYS OF DATE PERMIT iS ISSUED AND THEREAFfER IS TO�E DILIGENTLY PURSUED TO <br /> COMPLEfION.THIS PERMIT MAY BE CANCELIED BY THE CIiY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />