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SY /a< <br /> / PUEI¢WaeFePerm�t• ��� 3 <br /> Date �( Z y� Biaq oeo�.• <br /> Application For — <br /> WORKS PERMIT P"°"`W°"'"° s �"—=— <br /> PU B LIC To181`°° <br /> LeesAppl Fee Pa�O S��— <br /> g 'Zc7 � G U _ <br /> ealanco oue <br /> Print or Type Only ���97� <br /> r tr a�i �c� „�� <br /> BoYdeil RP 1 7n1Q Rrnadc..Y Z� Phone <br /> Owner <br /> `�SY''"' T �deilmg Address City P <br /> Boyden Realty, Inc. <br /> dba S 6 D Builders 1429 Broadway 5vexett 9S2C� 252-1166 _ <br /> qppiicant Mniling Address <br /> Cily Zip Phone <br /> Describe Proposed Work New Si_n�lP � <br /> � <br /> Prolect Address(it known) .3 — � <br /> Attach tour(4)copies ol plans tor proposed work- Draw to scale and nole�Ceo11ew�ne ol�PeCf`able�. � <br /> • Property Lines • Indicate Norih <br /> • (�utline and dimensions i�all existing and � Show any proposed grading changes <br /> rr,pc:ed stiuctures on tne lot � Show measurem?nts M <br /> • Existing and proposed utilities W <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS �\ <br /> 1. All calls lor ins�eclion sha I be made 24 hrs. in advance- phona 259•881 5. <br /> 2, All work sh&u be perbrmed in accordance with lhis permit and c��rrent City ol Everetl Design and Consiruction � � <br /> Stano6rds and Specifications. �y <br /> 3. Call Location Underground Service 4B h�s. belore you tlig.TOLL FREE NUMBER 1-800•424•5555. � �. <br /> �. <br /> O C; <br /> N ar <br /> r� .. <br /> o ' N ' <br /> � C <br /> C � <br /> C7 < <br /> y f <br /> O i <br /> r <br /> C: � <br /> � ' <br /> ACKNOWLEDGEMENf JFGONDITIONS � : <br /> The undersigned cwneqapplicant iieieby agrees to hold and save ha �•� .. � <br /> less the City ot Everett from any anA all claims tor damages, cr � ;� ; <br /> ezpenses, or causes ol action that may arise because of installati�•� � i <br /> /� and mainlenance o� lhe improvement or olher riBht-obway use here�o <br /> ��,/�.��� '�G � Fy applied tor and further agrees �o �smove same upon notice Irom ihe ,_, <br /> �GProve f r Co uclion Dale Ciiy a. d to replace publ'�c properry Camaged thereby. r � <br /> \ • �' � �' <br /> /; <br /> ,��z�l - �,�f ; 1;,;��,' �_���',: �!r , y_,, ,1��/ � : <br /> � � : <br /> FINAL INSPECTION ��� Date <br /> Signalvre ol Applicant <br /> ApProved as Const�ucted � WOHK AUTHORIZ[D BV THIS PERMIT MUST BE STARTED WITHIN <br /> evemlt PUDLIC WORKS DEPARTME�. 180 DAYS OF DATE PERMIT IS ISSUED AND THHREAFTER IS TO • <br /> � 3200 Cedar Slreet B[ UILIGENTLY PUHSUED 'O COMPLETION.TI115 PERMIT IJAY BE <br /> Everel�,WA 98201 pROJECT OVFR TO DAYS DUR�T ON SiOPPAGE OF WORK ON THIS <br /> Phone�. a59�B815 I <br />