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4 '12/91 `— � �•` <br /> Date � <br /> PuOhc Workf Parmn• <br /> Application For e'�e oeoi.. a__1_�__/967q7 <br /> PUBLIC WORKS PERMIT Puei¢wo�kaFee <br /> Tolni Fee S _ <br /> ' Less Pppl.FCe Fa�p $ <br /> Print cr Type Only e"�"`a0o° �— <br /> cs+nrqa Karr �501 m�lat�� FVr,rett 98201 $$Y}EpR�$ 252-4345 <br /> Owner Maihng Address Gty Zip Phonr <br /> Structures LTD 515 E 96th St Tacoma 98445 <br /> Applicant Mailing Address City Zip Phoi�e <br /> Deccribe Proposed Work _ �nStltlCt sunroom OVCT L'X15ting deCk <br /> W <br /> I'�roject Address lif known) 3601 Tulalin � <br /> Attach�our(4) copies of plans lor proposed work- Draw to scale and nole the lollowing as applicable�. � <br /> • Property Lines • Centerline ol street � <br /> • Outline and dimensions of all existing antl • Indicate North <br /> proposed s��uctures on ihe lot • Show any proposeA gradin� changes <br /> • Existing and Hroposed utilities • Show meas�remenls � <br /> DO NOl WRITE BELOW THIS LINE <br /> PERMITCONDITIONS O <br /> 7.All calls for inspection shall be made 24 hrs.in advance�Fhone 259•8810. � <br /> 2.All work shall be pedormed in acwrdance with ihis permit and current City of Everett Design and Construction <br /> Standards and Specifications. <br /> � 3.Call Location Underground Service 48 hrs.belore you dig.TOLL FREE NUMBER 1-BOU•424•5555. � <br /> � / /, r / /� / .,r� �J " /) � <br /> CJ/�-G'GL' C.UO2/�- /'_�,.h-..t.C' ��t '"�-!'�-L[t,2.:r1% <br /> �����i � <br /> ���-�i � � <br /> A <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/appliwnl hereby agrees lo hold antl save harm� <br /> less Ihe City ol [verett trom any and all claims lor damages. costs, <br /> czpenses. or causes of action that may arise because of installation <br /> and maintenance ol the Improvement or olher iigh4ol-way use hereto <br /> applied lor and funher agrees �o �emove same upon notice Irom Ihe <br /> Appwved lor Construction Date City and to replace public property damayed thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed Si9nature ol Applicant Date <br /> everell PUBLICWOPKSDEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> � 3200CedarStreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA 98201 BE DILIGENTLY PURSUED ?O COMPLETION. THIS PERMIT MAY EE <br /> Phonc:259�8810 CANCELI.ED BV THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />