Laserfiche WebLink
� <br />� <br />TYPE OR PRINT ONLY <br />Owner <br />Applicant <br />�-olication For <br />PUBLIC 1►rORKS PERMIT <br />PUBLIC WORKS GL^1RTMENT <br />3200 Cedar Slreet <br />Everetl, WA 98207 259-8810 <br />Plan Check No: <br />Applicat.Date: <br />Job Addreae: <br />Owner: <br />Tenant: <br />Propaeed Use: <br />Desc. of Work: <br />T.I. <br />Date <br />Public Works Permit N <br />Building Permit q <br />Publlc Works Fee 5 <br />B 53866 SEPA <br />Ol / 02 / 97 Phone <br />1716 W MARINE VIEW DR <br />DAVIDREVANST&IASSOCEL <br />OFFICE Phone ^� <br />Describe Proposed Work ._. oFFICE SET�_JOB ssT <br />APPROVED FOR PERMIT: DATE_/_I_ BY <br />PROJECT ADDFESS (if known) <br />qtlach four (4) copVes of plans for proposed work - Oraw to scele and note lhe lollowing if applicable: <br />•Property Lines 'Outline and dimer�sions of all ezisting and proposed structures on the lot •Fxisting and proposed utilities <br />'Centerline of slreet •Indicate North •Show any proposed grading changes •Show measurements <br />.... u�r �uoiTc GGI !lW THI.S LINE <br />PERMIT CONDITIONS: <br />1. All calis for inspection shall be made 24 hours in advanr,e - phone 259-8810. <br />2. All work shall be performed in accordance with this pen�,�t and current City of Everett Design and <br />Co�struction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 7-800-424-5555. <br />•ur��C ���o�+ts rF:�r�r' <br />;,�; nscufne+� <br />,v _�?f�'_ <br />�rT=----��3�5�7_-�_ <br />,4pproved for Construction Dale <br />FINAL INSPECTION Da�e <br />Approved as Constructed <br />W <br />� <br />�1 <br />N <br />V♦ <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applieant Y,ereby agrees to hold and save harmless <br />the City of Everett trom any an� all claims for damages, costs, expenses, or <br />causes of actlon that may arise because of installation and maintenence of <br />foe moveesame upon notice from the City andtolir placenpublic o operty <br />db,naged thereby. <br />Oate <br />Signature of Applicant <br />COMPLETION.TIH S PERMIT �. AY BE CANCEB EDTBYTHE CINIUPON ANY S�TOPP GE OF WORK ON THIS PROJEC 0 ER 90 DAYS DULRATION.Y PURSUED TO <br />