9420 1ST DR SE 2016-01-01 MF Import

- 8s— i9� �8te 7uElic Woda Pe:mit• �+ Application For eiee�oao�.• y/�� PUBLIC WORKS PERMIT P��W�«=Faa ,o�a�Fea s Lesa ApO�Foe Paid s Print or Type Only Balance Due s - O.� �7� 770/7 Bovden Real�v. Inc. 1429 Broadwav Everett 98201 252-1166 Owner Maiting Address Ciq� Zip Phone J & D '3uilders 1429 B_oadway Everett 98201 252-1166 Applicant Mailing Address City Zip Phone oescribe Proposed Work Sinelz Familv Residence - W ProjectAddress(itknow�) V42(1 — 7wr Ilrivr S_F._� 1?verett � Attach four(4)copies of Flans fo��roposed work• Draw to scale and note the follawing as applicable: � • Properry Lines • Centedine ul streel � • Oulline and dimensions of all existing and • Indicate North proposed siructures on ihe lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements � DO NOT WRITE BELOW THIS LINE O PERMIT CONDITIONS 1. All calls for inspection shall be made 24 hrs. in advance-phone 259-887$. � 2. All worh shall bn performed in accordance with this permit and wrrent City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 4B hrs.bebre you dip.TOLL FREE NUMBER 1�500•424•5555. � O �w _/ O a ACKNOWLeDC�:MENT OF CONDITIONS The undersigned ownerL.pplicant hereby agrees to hold and save harm- less lhe City c� =veretl from any and all claims lor damages, costs. /� expenses, or auses of a.:tion that may arise because of installation �r � .�Ci�_�„�./��_� � �� s and maintenance of the improvement or other �ight-ohway use hereto ��`� `�� applied for and lurther agrees to remove same upon notice Irom ihe ro ed lor onslruction Date City antl to replace public properry damaged Ihereby. % � �—� �� y�'_ ,A FINAL INS ECTION � Date �/-d�� C/1l AL d�i�A.�'� G-��—.Q.� Approved as Conslructed , Signature of Applica �ale everett PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE START-E� WITHIN O 3200CedarStreet 180 DAYS OF DATE PFRMIT IS ISSUED AND THEREAFTER IS TO Everelt,WA 98201 BE DILIGENTIY PURSUED TO COMPLETION.THIS PERMIT MAY BE Phone:259�8815 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PRUJECT OVER 90 DAYS DURATION.