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Date� Pu�lic\YoeksPermita �� �/ � <br /> BIOq.Oept� �S <br /> Application For <br /> PUBLIC WORKS PERMII• PuolicWaihsFee � ^ <br /> ialal Fea S �"'�'��V V <br /> Le9lADPI.FCO Pdld g <br /> 001BOCB�OB ��'�O <br /> Pnnt or Type Only 666 3�O <br /> A�en Realty, Inc• 1429 llroadwav Everet� 95201 252-1166 <br /> Owner Mailing Address City Zip Phone <br /> Soyden Realty, Inc., dba J & D Builders, 1429 Broadway, Everett 98201 252-1166 <br /> Applicant Mailinp A�Jdress City Zip Phone <br /> Describe Proposed Work New sinele familv residence <br /> Project Address(il known) 9506 – 7nd Aven�e S F of � �� � <br /> _ � <br /> Attach four(4)copies of plans for proposed w�ork- Draw to scale end note ihe lollowing as aUPlicable: � <br /> • Property Lines • Centerline of s;wet ♦^ <br /> • Oulline and dimensions of all eristing and • Indicate North V� <br /> proposed structures on:he lot • Show any proposed grading changes <br /> • Ezisting and proposed u ilities • Show measuremenis � <br /> 0�p N—',E BtLOW THIS LINE � <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection shall be mede 24 hrs. in advance-phone•2$9•8$1 5. ^ <br /> 2. All work shell be performed in accordance with this permit and currenl City ol Everett Design and Consiruction ♦ <br /> Standards end Spec�fications. <br /> 3. Call Locetion Underground Servi�e 46 hrs.belore you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> O <br /> �w <br /> _/ <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONI"� '1'JS <br /> The undersigned owner/applicant hereby agreer �.Id and save harm- <br /> --- less ihc Cily ol Everett Irom any ar,d all cla�� • damages, cosis, <br /> f– expenses, or causes of acti.n that may arise ^� use of installation <br /> � �� �� and maintenance ol the improvement or othe ,:4�o1-way use heret� <br /> applied for and lurlher agrees �o remove samo �pon nolice Irom the <br /> Ap � C struc lon Oate City and to replace puhlic property damayed thereby. <br /> � �/�� � � � ,- <br /> FINAL INSPECTION Date !��.�,— �` -- /�.�-- �G .. '�Y�� <br /> Appioved as Construcled \ Signalure of Apolicunt Date <br /> evere[t PUBLIC WORKS DEPARTMENT � WORK �UTHORIZED BY THi, PERMIT MUST BG STARTED WITHIN <br /> 180 ..AYS UF DATE PE7MIT IS ISSUED AND THEREAFTER IS TO <br /> � 3200 Cedar Slreet � BE DILIGENTLY PURSUED TO CUMPLETION.THIS PERMIT MAY BE <br /> Everett,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE O�WORK ON THiS <br /> Phone: 259�8815 PROJECT OVER 90 DAYS DURATION. <br />