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1 <br /> Date �� a/ � Pu��ic Worhs Permit s � � °�� � <br /> Application Por em9.oeo�.+ � <br /> PUB�IC VNORKS PERMIT Pu�1lcWorksFee ^ � <br /> To�el Fee s /T_' �� � <br /> Less POo�Fea Pe1G S <br /> BalanceDue $ ��u ' �� <br /> Print or Type Only 6���� <br /> Soyden Realty, 71c. 1429 Broadway Everett 98201 252-1166 <br /> Owner Mailing�address Ciry Zip Phone <br /> Boyden Realty, Inc., dba .T & ll Huilders, 1i29 Brcadway, Everett 98'LO1 252-1166 <br /> Applicant Mailing AdAress City ZiP Phone <br /> Describe Proposed Work New Single Family residence <br /> __ W <br /> Pro��ct Address(if known) 9509 — 2nd Dr. 5.E. — Preliminary � <br /> Attach lour(4) coFies o1 plans lor proposed work- DraH•lo scale and nole the tollowing as applicable. � <br /> • Property Lines • Cerlerline of street /A <br /> • Outline and dimensions of all existing and • In�ficate North V� <br /> proposed siructures on the lot • Show any proposed grading changes <br /> • Existi�g and proposed ulilities • Show measuremenis /M <br /> W <br /> DO NOT WRITE BELOW TH�S LING O <br /> PERMIT CONDITIONS <br /> 1. All calis tor inspection shall be made 24 hr;. in advence-Fhone 259•881 5. � <br /> 2. All work shall be porfo�red in accordance with this permit and current Ci�y of Everett Desiyn and Consiruclion <br /> Standards and Speciiications. <br /> 3. Call Location Underground Service 48 hrs.bsfore you dig.TOLL FREE NUMBER 1-800•424•5555. � <br /> O <br /> �w <br /> _/ <br /> � <br /> a <br /> ACKNOWLEDGEMENT OF CONOITIONS <br /> The undersigned owner/2pplicant hereby agrees�o hold and sava harm� <br /> less the City of Everett trom any and all claims for damages, costs, <br /> '�'� � expenses, or causes ol action that riay arise because ol installa�ion <br /> �� ��t f��_ ��_ z 2_�3 antl maintenance ol ihe improveme� 1 or other right-oF-waY use hereto <br /> applied tor and furiher agrees to �n�e same upon notice irom the <br /> Approve r n truction Dale City and to replace public propert�� aged thereby. <br /> FINAL INSPECTION � � � � � Dat /��` ' -•.�_ �� /� (�`_ :�� //-. �o .. y.'� <br /> Approved as Cons.�ucted > Signature ol Applicant ���e <br /> everett PUBLIC WORKS DEPARTMENT - WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 1A0 DAYS OF DATE PERMIT IS ISSUED AND THEREAF�iER IS T�� <br /> � 3200 Cedar Street RE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY '�E <br /> Everett,WA 98?01 CANCELLED BY THE CITY UPON ANY STJPPAGE JF WORK ON TFIIS <br /> Phone: 25°-881`. PROJECT OVER 90 DAYS DURATION. <br />