Laserfiche WebLink
�2t� PoEec Woihs Poprm`it♦ �/` <br /> �.,r— /2 9 <br /> a1a9De�t.� lJUlh �/ __ <br /> Application For <br /> PUBLIC WORKS PERIIdIIT '°'roWFee`°° s <br /> LesS RDot Fe5 PeiC $— — <br /> oaie��o o�� s_ 20..D0 <br /> Print or Type Only ���f/� <br /> Boyden Realtv• Inc 1429 Droadwav Everett __ 98201 252-1166 <br /> Owner Mailing Address Ci�y Zip Phone <br /> J & D Buildcrs 1429 Broadway Everrtt 98Z0'_ 251-1166 <br /> z <br /> Applicant 1.9ailing Address Ci1y Zip Phone o <br /> n <br /> m <br /> a��� .. <br /> Describe Pioposed Work New Sin�le Familv Re ' P an <br /> � T <br /> �--� y <br /> W � _ <br /> � <br /> � <br /> � o <br /> � . , � m � <br /> Prolect Address�il known) 94�4 lcr Ilr've 4 P F .a tY <br /> `_ 0 3 <br /> Altach four(4)copies ol plans lor proposed work- Oraw to scale and nvtr the�r;lowing as applicaule: � � Z <br /> • PiopeilY lines � Centerline of slreet = � <br /> • Indicate North m <br /> • Outline and dimensions of all existinq and '-' <br /> proposed struclures on ihe lot • Show any proposed gradn9 changes A z <br /> • Show measuremenis e <br /> • Existing and proposed utilities M a � <br /> W r = <br /> .. ... <br /> DO NOT WRITE BELOW THIS LINE A �N <br /> l 7 � -n <br /> PERMIT CONDITIONS r O T <br /> 7. All calls lor inspection shall be Tade 24 hrs. in advance • phcne 259•S81 5. � --1 m <br /> 2. All work shall be pertormed in accordance with ihis permit and current City ol Everett Design acd Conslruction m� <br /> Standards and Specilications. �' <br /> 3. Call Location Underground Service 48 hrs. belore you d��.TOLL F'FlEE NU�ARER 1•800•424•:i555. � <br /> c�'�m <br /> c �, <br /> O 3 tn <br /> m <br /> z c� <br /> -�r <br /> m <br /> n <br /> � A <br /> -� <br /> '^ a <br /> �/J � -, <br /> OA ~ <br /> 1e1� � <br /> � <br /> �, <br /> r <br /> m <br /> A.CKNOWLGDGEMENT OF CONDITiONS <br /> The undeis�.c�nrd o;�ner/applicant hereb��agrees to hold and save harr, � <br /> less Ihe Cily ol Everr.li lrom any ar.d aC cialms Inr damages, costs. <br /> eapcnses. or c�uses of acliun that may arise because ol installa;ion <br /> � `> / and maintenonce ol the Improvemeni or uther rigM�of�way usc herelo t;�� <br /> .C;/i ��.J�a�"�='� ��—�'� applied lor anJ Wrther agrees to remove same upon notice Irom ihe ;�1:fi <br /> Approved lor onstruction Date City antl to replace public proPerty dama{�ed thereby. t� � <br /> t <br /> - % Il z7��S ' n <br /> o��� �..— �- ��� s � a<�- <br /> FINAL INS CTIO atc <br /> Approvef as Constructed Signatare ol Applicant <br /> WORh AUTHORIZED BY THIS PFRMIT MUST BE STAqTED VVITI'.iN <br /> everett I PUBUC WOFi<:5 DEPARTPAEP:T 180 DAYS OF DATE PERMIT IS ISSUE`.D AKD TH[REAREF IS TO <br /> � 3200 Cedzr Sireet BE DILIGENTLY PURSUED TO COMPLETION. THIS P[RMIT M1tAY BE <br /> itp9 Everett.WA 9F201 CANCSLLED BY THE CITY UPON ANY STOP�AGE OF WORK ON T41� <br /> f� Phone: 259�8Et15 PROJEC7 OVER 90 OAYS DURATION. <br />