Laserfiche WebLink
�$�fY�� Pu011c Work�Permit• v � /• <br /> AppllcetionFor eieo.osai.. __ <br /> PUBLIC WORKS PERMIT PuEi�cWork�Faa <br /> TaulFee = <br /> less�oo�Fee P�iC = <br /> Print or Type Only Bainnce Due f a0.�� <br /> ^�i,�_? <br /> Boyden Realty, Inc. 1429 Broadway Everett 98201 252-1166 <br /> Owner Mailing Address City Zip Phone <br /> J 6 D Builders 142� Broadway Everett 98201 ?52-1166 <br /> Applicent Mailing Addr?ss City Zip Phone <br /> Deseribe Proposed Work New Sin¢le Faeillv Residence <br /> W <br /> Projoct Address(if known) — � <br /> Attach four(4) copies of plans for prcNosed work- Draw to scale and note the lollowing as applicable: � <br /> • Property Lines • Centerline ol streel � <br /> • Outline nnd r!Imens'ons of all exisfing and • Indicate Norih <br /> proposed atructures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements � <br /> DO NOT WRITE dELOW THIS LINE O <br /> PERMITCONDITIONS � <br /> 1. All cails for inspecticn shad be made 24 hrs. in advance- phone 259•881 5. � <br /> 2. All work shall be perlormed in accordence with this permit and current City of Everelt Design and Construclion <br /> Standards and Specificationa <br /> 3. Call Location Underground Servic=48 hrs. before you dig.TOLL FREE NUMBER 1-800•424-5555. � <br /> I O <br /> � <br /> � <br /> O <br /> a <br /> AC�(NOWLEDGEMF.NT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br /> less tlie Gi�y of Everett Irom any and r�l claims lor dameges, costs, <br /> i--� � �� expenses, or causes of action ihat may arise 6ecause of installatnn <br /> �—� "� " and maintenance of the improvement or other riqht-of-way use hereto <br /> /r =/�� — 1 � ��Nn��\� <br /> Approved lor ConSiruCtiOn � , Date aPplied lor antl luriher agrees to remove same upor notice from ihe <br /> � Ciry and lo replace public proper�y damaged Ihereby. <br /> �- - z ���� /� /� ��G�, / <br /> FINAL INSPECTION Date eF //�!/ '1,� �'���-����v � S��'1/�� <br /> Approved as Constructed Signature ot.�pplidanl Date <br /> everett PUBLIC WORKS DEPAHTMENT WORK AUTHORIZED F�Y THIS PERMIT MUST BE STARTED WITHIN <br /> � �3200 Cedar Street 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA 98201 BE �ILIGENTIY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:259-8815 CANCELIED BY THE CITY UPON ANV STOPPAGE OF'NORK ON THIS <br /> PAOJECT OVER 90 DAYS DURATION. <br />