1725 WALNUT ST 2018-01-02 MF Import

Application For TO 00�r PUBLIC WORKS PERMIT PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett, WA 98201 259-8810 TYPE OR PRINT ONLY xrorrn000 r,. •u C+I rr FRAN FS FORSYTHE '� 72 20. Bill Owner Mailing Address m i Applicant Mailing Address- • :? I.J fY a Describe Proposed Work NEW HOUSE — BA: PROJECT ADDRESS (if known) a - x POSTING Date.- 1/29/98 u+ Public Works Permit It R6log iu x Building Permit if 57768_ Public Works Fee $ L/ A 98201 252-9130 Attach four (4) copies of plans for proposed work - Draw to scale and note the following if applicable: Zip Phone Zip Phone •Property Lines 'Outline and di- sions of all existing and proposed structures on the lot "Existing and proposed utilities 'Centerline of street •Ind:.. North 'Show any proposed grading changes •Show measurements DO NOT WRITE BELOW THIF jd..". PERMIT CONDITIONS: 1. All calls for inspection shall be made 24 hours in advance -phone 2 _'-010. 2. All work shall be performed in accordance with this permit and current G;ty of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. CWr,e� roof -gyp drekVls 4 Sic6e seu,w V♦ ca O z O CA O a ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harmless the City of Everett from any and all claims for damages, costs, expenses, or causes of action that may arise because of installation and maintenance of the improvement or other right-of-way use hereto applied for and further agrees to remove same upon notice from the City and to replace public property damaged thereby. Signature of Applicant All Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.