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Date 4-21-92 <br /> Pu00c Worxe Permit• <br /> Applica�ion For e�ae�Deo� + 36456 <br /> PUBLIC WORKS PERMIT Pum�cWor�sFee s <br /> Total Fee <br /> less Rool.Fee Vai� s_ <br /> Balanca0ue S <br /> Print or Type Only <br /> STEVE S BARB TURNER 5703 WFST DRIVE EVERETT WA 98203 353-8597 <br /> Owner MailingAddress City Zip Phone <br /> OWNER <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work SFR ADD•d <br /> W <br /> Project Address�it known� 5703 WEST DRIVE � <br /> Attach four(4) copies ol plans for pmposed work- Draw to scale and note ihe following as appBcable: � <br /> • ProperlY Lines • Centerline of sheel � <br /> • Oulline and dimensions of all existing and • Indicate Nurih 7 <br /> proposed sirudures on the lot • Show any proposed graAing changes <br /> • Ezisling and proposed ulilities � Show measuremenls � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All calls for inspection shall be made 24 hrs.in ac iance-phone 259•8810. � <br /> 2.All work shall be pedormed in accordance wit!i this permit and current City of Everetl Design and Construction <br /> Standards and Specifications. <br /> 3.Cail Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> / l/O'c[�:. (,GJ�t/S� �lA�L�..�a.,/� /c�� ;�Fy�c«,1,��.� �[�,� O <br /> 6 ,i1'u <br /> � <br /> Lt��.� .�� ���,,.f,�iQ��y ��ti,-,�- y V� <br /> / �+ �J�/ � / !/ �Ln...� <br /> /� ��1 -�j�n�l� 1i.Cc.4�:i. / _'J<i �7�-)n�Cl-f-a.n-/.�' ,C<�-L L � <br /> / / �[ L. <br /> �L[L�— a.�.G.�t,.., ,4� �>„_�� li.,.•�[��-� ,�e«.,.✓,c'A ('�� � <br /> // <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm• <br /> less ihe City ol Everetl from any and all claims lor d�mages, costs. <br /> expense: or causes ol adion that may arise because ol instellation <br /> and mainlenance of the improaemert or other righbot�way use hereto <br /> ApProved for Construction Dale 3P�lied for and further agrees to remove same upon notice irom the <br /> C�ty and to replace public property damaged thereby. <br /> FINAL INSPECTION Dale — <br /> Approved as Constructed Signature of F,pplicant Date <br /> . PUBLICWORKSDEPARTMENT VJORK AUTfiORIZED BY THIS PERMIT MUST BE STARTEO WITHIN <br /> ���� 3200CedarStreet 760 DAYS OF DATE PEFiMIT IS ISSUED AND THEREAFTEF IS TO <br /> Everett WA90201 8E DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT M,1V BE <br /> �� Phone:259-8810 CANCELLED BY THE CITV UPON ANY STOPPAGE OF WORK O'�THIS <br /> PROJECT OVER 90 DAYS DURATION. <br /> — 1 <br />