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� �Ileatbn Fo� <br />PUBLIC WORKS PERMIT <br />PUBLIC WOFiKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 (9?5) �7�8�j <br />; � FOSTING�"" <br />TYPE OR PRINT ONLY <br />KHAN MONAMMED <br />owner <br />Dare 4/5199 <br />Publfc Works Pertnit N R"1 IZZ. <br />Building Permit k C62080 <br />Public Works Fee S _� <br />9330B STATE AVA /302 1,ARYSVILLE 98270 360-659-1135 <br />Mail�ng Address Ciry Zip phone <br />Applicant MallingAddress Ciry Zip Phore <br />Describe Proposed Work NEW HOUSE <br />PRQIECT ADDRESS (if known) _ <br /><'i3-S9 ,.,-.� <br />, ._. _�: <br />� .�.�� ' , _ <br />Anech lour (4) copies plcns lor proposed work • Draw to scale and note the fWlowinp II appliceble: ..,, - .,. _, <br />• Propery Lines • Outline and dimensions ol all existing and proposed stmctures on Ihe bt • Existing aMp(oposed utllitles .' <br />• Centedine of sheet • IMicate NoM • SMw any proposeA grading changes • Show measurements �'r',C�?G . �. <br />DO NOT WRITE BELOW THIS LINE ='nj'`" . <br />PERMITCONDITIONS: � �.y ` � �"'"� � <br />U •(fp� <br />1. All calls for inspection shail be made 24 hours in edvance - phone (425) 257-8810 , q�:: : �,.�,- <br />2. All work shall be peAormed in acccrdance with this permit and current City ot Everett Design and ;..- <br />Construction Standards and Specifications.. ;�; -,: <br />3. Cail Locatfon Underground Service 48 hrs. betore you dig. TOLL FREF NUMBER 1-900-�21-5555. . <br />,� _ <br />�, Cv►�� �o�,�� ►^unof� %� Sidascw�ir• .. _,.;s= <br />�, �;�.,:� <br />5, �x4'ivJi�� f9rudth� Sh�ll 4.� den.� in � wrrn►�,�,- �Chatw�ll no�, <br />'i ►����k �dj�uM�t �a �.�ts. <br />a� - <br />W <br />� <br />� <br />Y/ <br />� <br />� <br />a� <br />ACKNOWLEDGEMENTOFCONDRIONS <br />The uMersipned owner/applkant hereby agrees to hold and save hartnless <br />Me Ciry of Everett irom eny a�M ell claims kr demeyes, oosd, axpenseg, or <br />ceuses of acifon thal may ariae beceuse ol insfalletlon and mslnMrw�ce of the <br />imprwe or otl�m iight�ol-wey use herelo epplbd br and IuNbr eprses lo <br />remove rti:nce hom nre Cib' ��� P� P�why dam. <br />aged reb <br />�1�, �3%9g <br />°"� re ° T <br />IM�RK AUT}10Fi�D l)Y THIS!'6iMi MUST BE STARfED WRHW 1B0 DAVS OF M7E PEFi�! IS ISSlB) MD7}fFEAFiFR IS 70 BE DIIOBlILV P1�191�D10 <br />COMPLEiION. THIS PE'r?MR MAY BE CAN((�JAID BY THE CRY UF'ON ANV STOPPAOE OF N�Fi( ON TF#S PHO,ECTONER 9D DAVS IX1M1qN <br />� <br />