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i •Date� =�y �5 <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Tyne Only <br />Robert Oravetz 3820 Wetmore <br />� �Pu�l�r, Wo.ks PCrmi� • q <br />BiaG ��ot+ � J � .f- � <br />Pat���cWorksFea $ <br />total Fee <br />Less A, pl Fec Faia 5 <br />Balance O�,�e $ <br />Everr:tt 98201 <br />Owner Mailing Adtlress City <br />Everett Builders inc. 5606 Evergreen Way Everett <br />Applicant Mailing Address City <br />Describe Proposed Work Construct 20' x14' Deck <br />Project Address (il known) <br />259-4430 <br />Phone <br />98203 353-7161 <br />Attach four (4) copies of plans for proposed work - Draw �o scale and nole the following as applicable: <br />• Property Lines • Centerline ol streel <br />• Outline and dimensions ol all existing and • Indiwte North <br />p:oposed strucfures on the lol • Show any proposed grading changes <br />• Existiny and proposed utllities • Show measuremenis <br />PERMIT CONDITIONS <br />1. All calls lor inspaction shall be made 24 hrs. in advance - phone 259•881 5. <br />2. All work shall be performed in accordance with this permit and curreM City of Everett Design and Consiructien <br />Slandards and Specifications. <br />3. Call Location :Jnderground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1-800•424•5555. <br />/UD �>�'G i G Gl�Di_;.�5- i�F,�'/n�T <br />��Q C��i�E/� %" �' <br />�Cn..iv `-�?; =8S <br />� <br />Approved for Construction <br />FINAL INSP[CTION <br />Approved as Constructed <br />evcrell PUBLIC WORKS DEPARTMENT <br />� 3200 Cedar Sireet <br />Everett, WA 98207 <br />Phone:259�8815 <br />W <br />H <br />� <br />� <br />O <br />♦�A <br />V/ <br />� <br />a <br />ACKNOWLEDGEM1IENT OF GONDITIONS <br />The undersiraned ownedapplicaN hereby aqrees to hold and save harm� <br />Iess the City ol Everett ironi any and all claims for damages, cosls, <br />r;,penses, or causes ol aclion that may arise because of installa;ion <br />and maiNenance ot the improvement or other right-ol�way use hereto <br />applieA tor and lurther agrces to remove same upon notice Irom the <br />Date City and lo replace puUlic piope�ty damaged ihereby. <br />Si4natwc ol Applicant Da�e <br />WORK AUT110RIZED �Y TfiIS ^ERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE P[FMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PUHSUED TO COMPLEiION. THIS PERMIT MAY BE <br />CANCeLLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />