Laserfiche WebLink
� Datel��'r'_"T'.3 PUGpt\Ynrhs Permd. a3 3 1 (e <br /> `� / .� <br /> eme uooi + <br /> � Application For <br /> PUBLIC WORKS PEF�MIT ppp1pW016Fe _ <br /> $ �,.,�, � � <br /> Tolal Feo <br /> Lf.59 ADO�FCB PBitl $ <br /> �a�ance Dua ���� � � <br /> Print or Type Only 6��3� <br /> Everett 98201 25?-116G _ <br /> Ownor Mailing Address City Zip Phone <br /> Bovden Realtv Inc dba J & D Builders 1429 Broadway Everett 98201 252-1166 <br /> Applicant Mailino Address City Zip Phone <br /> Describe ProFosed Work New Single Fanily Residence <br /> W <br /> ProjectAddress(ifknown� 950'L — 2nd Avenue S.E. o� � �y � <br /> Attach four(4)cOpies of plans for proposed work- Draw io scnle and nole ihe followin9 as applicable: � <br /> • Property Lines • Centerline ol streel � <br /> • Outline and dimensions ol all existing and • Indicale North <br /> proposed structures o�the lot • Show any proposed gra�ling chanpes <br /> • Ezisting and proposed utililies • Show.neasuremen�s M <br /> � W <br /> DO NOT WRITE 6ELOW THIS LI��E O <br /> PERti7T�:G VDITIGNS <br /> 1. All cai�::'.�•�^cpection shell be made 24 his in advance-phone 259•8815. � <br /> 2. Ail work all be per{ormed in accordance with ihis permit and current Cily of Everet� Design and Consiruction <br /> Standar lo and Speciticatlons. <br /> 3. Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMUER 1•800•424•5555. � <br /> 5�z9 1�1.A..ee� �/in1 �,,,,.o..Q O <br /> . rA <br /> V♦ <br /> �/ <br /> a <br /> ACKNOWLLDGEtAENT OF CONDITIONS <br /> The unde:signed owner/applicant hereby agrees to hold 2nd save harm- <br /> less thc Clty of EvereU Irom any and all claims for damages, costs, <br /> � ,, � expense�. or causes ol action that m�y arise because of installation <br /> �/'�/: /� /."� '/y,'�3 and mni� :+nance ot ihe imProvemenl or other right-ef-waY use herelo <br /> L� '�y applie� dnd luriher agrees to remove some upon nolice Irom lhe <br /> pproved tor Conslruclion Date City ai ��place public property damaged thereby. <br /> t` J 4Z ' , <br /> S' 7/5 � ' _ `. �r.-� /G�� �-d'._i <br /> FINAL IN PEC ION Date t `"- " — <br /> Approved as Construcled Signature ol Applicant Date <br /> 1NfJRK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> everett PUBLIC WORKS DEPAHTMENT id0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> � 3200 Cedar Slreet BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Everett,WA 98201 CANCELLED�Y THE CITY UPON ANY STOPPAGE OF WGRK ON THIS <br /> Phone: 259-BB15 PROJECT OVER 90 DAYS DURATION. <br />