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r�excvm�w�ae���n ��✓�—/'�D — <br /> Date�at� �l /VFG 1. <br /> 61ep Deo� • <br /> Appficetion For � <br /> PUBLIC WC'iRKS PERIIAIT PuOTa�FeeFea s <br /> - �cas noni.Fee Pmo S /� <br /> Baiance D�e S ����OV <br /> Print or Type On',y ,��37 <br /> Boyden Fealty, Inc. 1429 Broad�ny L•verett 98201 252-1166 <br /> ON�ner Mailing Address City Z�p Phone <br /> z <br /> 14::9 Broadway Gverett 95201 252-1166 0 <br /> ,T & D Buildc;s _ �-�» <br /> Phane � <br /> ApPfceN Mailing Address CiIY Z�P m <br /> Describe ProposeA Vvork New Single Family Residence _ � � <br /> .—��--1 <br /> V1 S <br /> 0 <br /> m <br /> --— � c o <br /> mo <br /> � <br /> � � m <br /> ProiectnJdress(ilknownl 9409 - 2nd Dri�•e: S.fi•, Everett ___ � z <br /> �� m~ <br /> At�ach lour(4)copies ot plans 1or proposed work- Draw to scale�nd note the lol�owin9 as appliwhle. � Q Z <br /> • Property Lines • Cemerllne ol sUect � <br /> • Outline and dimensions ol rJl axisting and • Indicate North <br /> • Show any piopOsed gradin�changes H,_.., <br /> croposed 5�rucWres on lhe lot p Show mea5uremeMs M � �' <br /> • Existing and proposed:.tilities W '� <br /> o � <br /> DO NOT WRITE BELOW THIS LINE O �D <br /> –i r, <br /> PERMIT COiJDITIONS � r� � <br /> 1. All calls lor inspection shall be made 24 hrs. in advance- Dhone 259•881 5. �� <br /> 2. All work shall be performed in acwrdance with this permit and currem Cily of Everetl Design and Consiruction o m <br /> Slandards and Specifications. � � �^ <br /> 3. Ceil location Underground Service a8 his. betore yoc dic�.TOLL FREE NUMBER 1•800•424-5555. ��, <br /> �r <br /> o . m <br /> x: <br /> s� <br /> _I v. <br /> � C <br /> --� <br /> a � <br /> m <br /> ACKNOWLEJGEAIENT OF CONDITIONS <br /> The :igned owner/applicant nereby awees to hold antl save haim� <br /> — - les: " Gity ol Everott Irom any end r-:J daims lor damages, costs, <br /> ex� � ��•s, or causes ol action that mc,y arise because ol instnl:alion <br /> ��� ���i O ard �ozintenance of the irrorovement cr olher right�obway use hereto <br /> Sti '�_S applieA for and further agrees to remo�e same uUon no�ice irom the <br /> Appruved'or Constructi Date C�ty�nd lo replace public pioperty damaged ihereby. <br /> /� '� / � – <br /> // � 1�"'i'�%1����" _% _ ��+ �•G'� <br /> Y �� �/. /�!-: <br /> FI�JAL IfISPECTION '�Date pale <br /> Approved as Conslructed SignaWre of ApPl�cant <br /> WCRK AUfHORIZED BY THIS PERMIT IdUST BE STARTED WITHIN <br /> evereU PUBLIC WORKSDEPARTM_ T 1G0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTEFi IS TO <br /> 3200 Cedar Street BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> �1 Everett,WA 9B201 CANCELLED BY THE CITY UPON ANY S70PPAGE OF WORK ON THIS <br /> Fhonc: 25&BB15 PROJECT OVER 90 UA1B DURATION. <br />