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N ~ _ _ — - _. .__ _ <br /> � 6/9/92 r�u��w�,ks c��m�i. <br /> y Datn--- 364G2 <br /> p� G Biap OeDt�_-. - —---- —— <br /> C y Applicalion For <br /> � � � PUBLIG WORKS PERMIT °°°°`"°'"„" ------ <br /> ,o„�.Ba s <br /> O � O ��.ssnon� n.�.aa,n S <br /> �V M �1 L:i a �„��n 5__— _ <br /> y � Print or Type Only <br /> � � � <br /> }}44{{ James Gison 3311 Shore Ave Everett 98203 348-0765 <br /> H <br /> '�., � � p�y��i,� Mailing Addre:5 City 7ip Phone <br /> � N <br /> N Ayer Construction 6525 Beverly Blvd Gverett 353-6427 <br /> y �"� ppplicant Mailing Atldress Cdy Zip Phone <br /> O N <br /> � � � <br /> '� y Descrme Proposed work 3311 Shore Ave - Carage Addition <br /> N <br /> W <br /> Project Adtlress�if knownl 3311 Shore Ave � <br /> Ftl�d��our 14)copies of plans lor pr000sed work- Draw to scale and nole ihe following as aPPlicabic� �� <br /> • Pruperty Lines • Centerline ol sireet ♦^ <br /> • Ouiline.nd dimensions of all exisling antl • Indicate Norih V� <br /> proposed slructures on ihe lot • Show any proposed yradiny chan�es <br /> • Existiny and proposed utilities • Show measurements M <br /> W <br /> �� DO NOT WRITE BELOW THIS LINE <br /> i.. . _ \ O <br /> I �� PERMITCONDITIONS <br /> 1.All caiu lor inspection shall 6e matle 24 hrs.in a0vance�phone 259-8810. �\ <br /> - 2.All work shall be pedonned in accordance with this permit and current City ol Everett Design antl Construction ♦ <br /> 1 Standards and Specilications. <br /> . '�� 3.Cail Location Underground Service 4B hrs.bebre you dig.TOLL FREE NUMBER 1•800•424'S555. � <br /> ��� <br /> � � � <br /> ��_ � „� . <br /> . �.-.�( , �_ (c.r'(� _ . . � ."-� '� �.rCiL. i� <br /> t <br /> i s� ���, � � <br /> �� �' �` ' ` � <br /> �� O <br /> a <br /> __ <br /> �i ACKNOWLEO�EMENT OF CONDITIONS <br /> � 'hc undersi�ned owner/applicant hereUy ac�rees to hold and save harm� <br /> I �_' ' � �— Ir.ss Ihe Gty of [eerelt Irom any and all claims lor dama9es, cosl:: <br /> � expenses, or causes ol ac�ion �hat may arise because ol installa�ion <br /> �, ❑nd maiNenance ol the improuer-enl or othCr ughi-obway usa herct. <br /> applieA lor and lurther agrees to remove same upon notice Irom Ihr <br /> Approvetl for ConsVuct�on ��'�O Cdy and to replace public propeiry damaged Ihereby. <br /> FINAL INSPECTION ���� --- pate <br /> Approvetl as Conslructed Siynatwe of Applicanl <br /> � WORK AUTHORIZED OV THIS PERMIT MUST BE START[D WITHIN <br /> 'V� PUBLICWORKSOEPARTMENT 180 DAYS OF �ATE PFRId1T IS ISSUED AND THEREAFTER IS i0 <br /> 3200 Cedar St�eet BE DILIGENTLY PURSCED 70 COMPLETION. THIS PERMIT MAV B[ <br /> Evcrelt,WA9B201 CANC[LLED BY THE CITY UPON ANY STOPPAG[OF WORK ON TNIS <br /> • Phonc 259�E1810 PROJECT OVER 90 DAYS DURATION. <br />