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Appiiceclon For / I <br /> � PUBLIC WORK� PERMIT oaie _ 1-11-99 _ <br /> PUBUC WORKS DE?ARTMENT Public'"brks Permit N � / <br /> 3200 Cedar Sireet <br /> Everetl,WA 98201 259•BB70 Building Permit N f�.l,��_.__—--. <br /> TYPEORPRINTONLY . , tnSTING � 0 6 � Publk\YaksFeet�/-- - __ _--. - ,I <br /> Wes Ingrum 2312 136th P1 SW Lynnwood 98037 425-742-8487 _ <br /> Owner MaiNng Address Ctty Zip Fho�e <br /> Owner <br /> Applicant Malli�g Address City Zip Phone <br /> Describe Proposed Work new house � <br /> � <br /> � ' <br /> � I <br /> PROJECT ADDRESS(ifknown) 4203 Crescent Ave } . � <br /> Atlach lour(4)copies of plans for proposed work-Drew to scale and note the folbwi�g B applicabie: O <br /> •Property Lines •Outline and d!mensions of all ezisting and proposei structures on tha lot •Existing and proposed uti1N(es <br /> 'Centedine of street •Indicato North 'Show any proposed 9rading changes `Show meesu�ements � I <br /> �O NOT WRITE BELOW THIS LINE <br /> PERMIT COIVDITIUNS: � <br /> 1. All calls for inspection shall be made 24 hours in advance- phone 259-5810. <br /> 2. All work shall be psrformed in accordance with this permit and curtent City of Everett Design and O I <br /> Construction Standards and Specifications. <br /> 3. Call Location Unde�ground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-4245555. H <br /> q"� COn� �"D0�0.� fU✓l�� -�D s i�Z 52wr'if', N I <br /> 5. s,de 5�e�' �5 }x�r y�d p��n ��oi � <br /> �, �h��re drev�ewc� Shal( �e Pa,.ed w;-�n � V ��5c�;o� a <br /> �vld 9r�� -fD Inc9t,� rvn of� -f� �he G.F3. �h �"'resce,��l�. i <br /> i.__A:7_�G �J.:�_• '. � <br /> U f.13�:. <br /> iUi�_� 543.'�� <br /> 'i_'JPiB '17.00 <br /> ECW bC .i;t� <br /> c�-:i,H�" .�v <br /> , .;if�` . .: , . <br /> ACKNOWLEDCiEMENT OF CC�NDIT10N5 <br /> ,,�n �� The underslgned owner/applicant hereby agreesto�:old and save hartnless <br /> �f�� the Ciry of Everatl from any end ell clalme for dameges,costs,expenses,w <br /> Approved or Con truction Da e causes of action that may edse because of Installetbn and meiMenance of <br /> the improvertient w other right-of-way use heraro applied forsW futher agroee <br /> to rertave same upon notice hom the Ciry antl.to reFilace�piiblic property- � <br /> ��C✓ `/�'S'�,J- damaged thereby. � . . <br /> FINAL INSPECTION Date �� <br /> P,pproved as Constructed <br /> Q✓ ,..�,� z/Y�i9 <br /> Signature of Applicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 1B0 DAYS OF DATE PERMR IS ISSUED ANG THEREAFfER IS TO BE DIIJGENTLY PURSUED TO <br /> COMPLEf10N.THIS PERMIT MAY BE(:At10ELLED BY THE CITY UPON ANY F fOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS WRATpN. <br />