Laserfiche WebLink
�Iax7� <br />C H <br />rHtn <br />K 1-3 W <br />k+U H hd <br />z <br />OS <br />OyC <br />Hag <br />Q. n <br />z H <br />H <br />H co <br />N <br />Cg3erA <br />z t-3 Cn <br />ra0CA <br />C: <br />t <br />"lilillia Aft, <br />,- Will <br />i --W <br />Date is <br />Work, Pirelli <br />Application For <br />Bldg part. <br />o� <br />PU�..IC <br />WORKS PERMIT <br />PaekcWorxaree <br />$ <br />Total Fee <br />O <br />n <br />r, <br />Tn p/� T 1 <br />1 1 1 !' 1 ' C 1 I ��7 (j. <br />Less APPI. Fee Paid $ <br />-xp <br />� �G/�L $ Lo�i <br />Print or Type Only <br />U <br />Ct�v D� �n <br />r �jl_!-v)na �YtnrE i�t'e <br />F✓eye /� `1�Za✓ <br />159—� 70 rJ <br />O—��r�Mating Address <br />o_ a a <br />City Zip <br />Phone <br />ru o <br />Describe Proposed Ifork 'AIR <br />J' - 12 mot_ 2-0 <br />Prolert Address (if known)-'�9- 'ejUe-4c - &kc. <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: <br />• Property Lines <br />• Centerline of street <br />• Outline and dimensions of all existing and <br />• Indicate North <br />proposed structures on the lot <br />• Show any proposed grading changes <br />• Existing and proposed utilities <br />• Show measurements <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in advance - phone 259.8810. <br />2. All work shall be performed In accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800.424.5555. <br />CUm _zla� L-1 c_li„a- /ae-L- 14a,>G a <br />COL <br />ae l <br />Approved for Constru� ale <br />FINAL INSPECTION <br />Approved as Constructed <br />i <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett. WA 98201 <br />Phone: 259.8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />Uj <br />/war <br />ca <br />O <br />n <br />z <br />O <br />Fm <br />V♦ <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City of Everett from any and all claims for damages, costs. <br />expenses, or causes of action that may arise because of installation <br />and maintenance of the improvement or other right-ef-way use hereto <br />applied Inr and further agrees to remove same upon notice from the <br />City and o replace public operly damaged Inereby. '1 <br />Signature of Applicant <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />Pr OJECT OVER 90 DAYS DURATION. <br />