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D�te���iSS� I PuGLc11'O�A9{'Bm,. —, S-/l�- <br /> e�aa oeo�.� <br /> qpplu:ati0n Fv�� <br /> PUBL�C WORM�S PERMiT IPubTo��ee��� _ <br /> - Ls>nod.r�,o Fa�a g <br /> DapnceD�n $ �•OO <br /> Print or Type Only 7G 0 -�J} <br /> Bo 9en Realt Inc. 1429 Broadway Everett 98201 252-1166 <br /> Owner Mailiny Address City Zip Phone z <br /> 0 <br /> -.� <br /> J 6 D Builders 1429 Broad�:ay Everett 98201 252-1166 � <br /> n <br /> qpplicent Mailin9 Addrecs City 7ip Phone <br /> � 'n <br /> DescribeProposedWork New Sin���e Familv R��idence .— ....� <br /> v+ x <br /> — o <br /> m <br /> co <br /> mo <br /> — � n <br /> -� c <br /> 03 <br /> m <br /> � -i z <br /> Prolect Addrr,ss�il nnown) _ 940� - 2nd DTi vp S.� Everet[ _ ~ <br /> m <br /> � A Z <br /> A�inch low(4)copies ol plans lor proposed work- Draw ic scale and nole Ihe lollowin9 as applica6le: � � <br /> • Property Lines • Cen�erline ol sireet s' ~ <br /> • Indicale North r <br /> • Ou'line ard dimensions of all existmg and `� � <br /> • Show any proposed grading changes K�' <br /> propused siructures on Ihe lot • Sha++measurements M '� <br /> • Exi5ling and propOsed ulililies W <br /> '�i b <br /> _ <br /> 00 NOT WRITE BELOW THIS IINE O =m <br /> m� <br /> PERMIT CONDITIONS � <br /> 1. All calls lor inspection shall be made 24 hrs. in advance- phone��59•881 5. � �m <br /> 2. AV work shall ue oerlormed in accortlance with Ihis permit antl curren;City ol Everett Design and Cc�islructlon ^ N <br /> 3 �+ <br /> Standards and Specilications. � m <br /> 3. Call Location U�JeryrounC Service 48 hrs. belore you dig.TOLL FREE NUMBER 1•800-424•5555. z n <br /> -1 r <br /> • m <br /> a <br /> O � <br /> -a <br /> x• <br /> L <br /> � . Z <br /> 'w z <br /> _I �. <br /> � C. <br /> � <br /> (' <br /> a � <br /> i1CKNOWLEDGEMENT OF CONDITIONS <br /> 7he unders�g��ed owneriapplicanl hereby a,c,reee to hold and - �arm� <br /> - Icss ih^ City of EverMt Irom any and all claims fo� tlami � usts, <br /> eapenses, oi causes of aclion Ihat may arise bec:.use o1 � ,.ation <br /> � 7 3 .,,.,5 and maintenance ol thc improvement or o'hvr �i�h4ot�H�a� . herelo <br /> °� A � �J�sf apphed ter and further agrees to remrne same upon noti� �.�om the <br /> Approved lor Co uclion �a'�e � City and to replace puhlic properry d3maced thereby. <br /> /'/� . ♦ <br /> �/��j1�/ , /Y, G- __� /y �, ���2� y"� �d� ,.c.�,� ..�,1�.% <br /> FINAL INSPEGnUN ����' Dale <br /> ApUroved as Consiructed Signature of APPlicanl <br /> VJnRK AUTHORIZED BV THIS PERMIT MUST B[ STARTED WITHIN <br /> ���everetl PUBLIC WOPKS DEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUFD AND TNEREAFTER 1� TO <br /> 3200 Cedar Stree.t I DE DILIG[NTLY PURSUED TO COMPLETION. T:11S PERMI7 MAY BE <br /> Evcret!, WA 98201 CANCELLf_D BV THE CITY UPON ANY STOPPAGF OF WORK ON THIS <br /> � {'ho�,.r :`�'?-R815 � f`ROJPGT�',•n=l: °�0 (�.11'S f�U9ATION <br />