Laserfiche WebLink
� <br /> 8/9/91 I:- 1 —� � .-�" P�oi��wo�x.v�,,,�i. �� b . <br /> Date o,�,q o�p� • 91/27511 <br /> qpplic::l�on For _ <br /> PUBLIC '+NORKS PERMIT FueecWortaGee _ <br /> To�a�F�� s <br /> , / LI ' �r �rse acoi r�e v..�a 5 <br /> T(? P05TING—�� �� Ba�T��.�o„� 5 zo — <br /> �"� Print or Type Only <br /> ,o�Ax <br /> �?y y i;ric Jacobsen 128 Sunset Ave. tidmonds 98020 334-1533 <br /> y �3Owner MailingAddress City Z�p Phone <br /> z <br /> .a o , <br /> H Xl <br /> O x O Ci1y Zip Phone i;t � <br /> � y H ApPGcanl hiailing Address <br /> H Z t" — <br /> � �.Qj. d Ucscribe Proposed Work New 1606 sf rambler <br /> � H <br /> `�'� - W <br /> z ra <br /> r r-i H ���-�-'L� L O � � 'l O __ � <br /> ���yyy � Prolecl Atldress lil known) <br /> H � <br /> � ty y Attach lour(4)copies ol plans lor proposed work� D�aw to'..:ale and nole Ihe�oliowing as applicable'. � <br /> • Property Lines • Centedine of street <br /> � C� • Outline and dimensions ol all eaisting antl • Indicate North <br /> Z H V� proposed structures on ihe lot • Shaw an/proposed gradin�7 rhanges <br /> y 0� • Show measwemenis M <br /> • E-isting and proposed utilihes W <br /> �O NOT WRITE BELOW TF��S LINE O <br /> PERMIT CON�ITIONS � <br /> i.All calls lor inspection shall be made 24 hrs.in advance�phone 259•8810. <br /> 2,All work shall be pedormed in accordante with this permit and current Gily of Everett Design and Construction <br /> S�antlards ana Specilicalions. � <br /> '�► .�' 3.Call Locetion Unde�ground Service 4B hrs belore you dig 70LL FREE NUMBER 1 800•424•5555. <br /> �" � ��. Install iocF, < <�n-tr-i.i�t-i.��n en� ranr„�. h-,i�i,nd drr;�,��„ - r��::�� �-, � � O <br /> �.tandaid A;OG >n�l cr�n - �,i�� � �. i Irnl a dir��ctcJ b�i Fublic b:orks <br /> InspeCtor. <br /> ��,,, ~� 'S. FiF�o c.itY str�ets �lean at all ti.mes � <br /> � - ,. Ci.ir-b autter and sidewal4�. in the plat are new and undamaqed. <br /> � ..�n�� damaqe F.hereto shall 6e replaced at the dis�retion of hh�� ,w <br /> I'isblic �lorks Inspector. v� <br /> '�` � . . Finv chanae in thc drivewav cut must be approved bv the P�.�bi ! ,: O , <br /> � ldor-L�.s In�pector. <br /> ,� i3. l'.iqM-.li.ne all rooi-, yard ana dri.vewai drai.ns to st.or��-� �Ira� n /� <br /> a,�,� =_tubs at bac4�. side oy' sidewal4� . ��� <br /> ^. Fld5us1� �iaier bo;:e�=- to arade at: end uf construction . <br /> 10. Dri.veeia.,.= ����.�t ) Lo ❑av�d fr"m I�:�cl� edae ot -idew�ll:. a �uin�mi�in ot <br /> 1 <br /> �-�� � .'.(i icot in'tu I� . " 31 'i ��'. � '.-" ����:.'����i"'�I lii�� l "�� I� �����ACKNOWLEDOEAtENTOFCO�NDITIONS <br /> The undersigned ownedappGcan�hereby ag�ees to hoid and save harm� <br /> nJ� less Ihe Gry of Evereu from any anA all daims lor damages, costs. <br /> � t`�q eapenses. o� causes ol actim� ihat may anse 6ecause ol instollation <br /> �� �f� and mainte�ance of Ihr impmvemenl or otiier righi�ol�way use herelo <br /> ' �p�t� � � �Q� v �� �' apPlied �or antl Wriher a9rees to remove same upon notice Irom Ihe <br /> Appioved lor Construc � d Date City anA lo replace Pub!ic p�operiy damaged the�eby. <br /> �"ZC// /Y '�/ � �// j'; j,t{i Cl w"�r�t7-" \ <br /> FINAL INSPECTION Dale � Da�e <br /> Si9nalurc ol AUV�ican <br /> Appro��:d as Cons�ructed <br /> WORK Al11MORIZED BY TNIS PERMIT MUST Bc STARTED N!I , <br /> t���{{;;ii''�-' PUBLICWORKSDEPARTMENT 180 DAYS OF DATE PERMI7IS ISSUED AND T4EREAFTGR IS -0 <br /> 7�`.�� 3200CetlarStreet i BE DILIGENTLY PURSUED TJ COMPLETION. THIS PERMIT MAY B[ <br /> y Evcret�,WF 98201 CANCLLL[D�Y THE CITY UPON ANV STOPPAGE OF N'ORK ON THIS <br /> P��.on¢259�6010 I F� .-JECT OVER 90 DAYS DURATION. <br />