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- PUBLIC WORKS PERMIT Date: 10/8/2012 <br /> ''� ' Ciry of Everett Public Works Department Public Works Permit#: PW1210-005 <br /> ,�. �y T�.�� 3200 Cedar Street Buildinp Permit#; C1209-007 <br /> Everett, WA 98201 Planning Reference#: <br /> (425)257-8810 <br /> Public Works Fee$: $ 25.00 <br /> Other S: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> PRESHAW IAWRENCE <br /> 3515 SHORE AVE <br /> EVERETT WA 98203 <br /> PHONE: 4253477081 PHONE: <br /> TAX PARCEL ID# 00433600000300 SITE ADDRESS: 3515 SI10RE.AVE <br /> DESCRIP710N OF PROPOSED WORK: <br /> NEW HOUS[ <br /> PEI?MI I'CONDITIONS <br /> 1. .411 cr+lls for inspection shall be made 24 hours in advance. <br /> 2. A'��vork shall be performed in accordance with the permit and current City of Everett Design and Construction Standards <br /> and Specifications. <br /> 3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 <br /> T <br /> r i �f'��i <br /> en c� <br /> r i-- r-� r--�--i�i--�r.. _i_ �- � <br /> � <br /> L7r--�-cnsa�.rr.c-ir.u��iTic�c3 0 �"� <br /> i, c � "'C�'i�� K., F�1 <br /> o � m � � <br /> c5 �' � <br /> � i <br /> � � ...� <br /> r <br /> r� �'A <br /> �I �rn� � <br /> ''y�r����i� a���vR�i<'a r <br /> �;�'v�cn�o�`�acrr.��' <br /> m F"'�.r--�c+c-,�,�:�n,�.� �.i <br /> F.... : C�f—'1`aLIO�Ga(�.T. y ;� <br /> ! <br /> H � <br /> � <br /> ACKNOWLEDGEMENT OF CONDITIONS � <br /> The undersigned o�vnedapplicant hereby agrees lo hold and <br /> save harmless the City of Everetl from any and ali claims!or I <br /> damages,cosis,expenses,or causes of action that may arise � <br /> �^ / / because o(installation and maintenance of the improvement � <br /> ��/` (QI� /� or other right-o6way use hereto applied(or and further agrees i <br /> to remove same upon notice from the City and to replace <br /> Ap vy f r Con�st sti� � Date public property damaged Ihereby. � <br /> ��-c` 'L�/��,:- � - 2( �- (3 1. i� <br /> �INAL INS CTION Date �'`�'� �U�r�� � I� <br /> Approved as Constructed Signature of Applicant Dale <br /> 7JORK AUTHORIZED BY i1i15 PERMR FiUST BE STARTED WITHIN 180 DAYS OF DATE PERMff IS ISSUED AND T}1EREAF7ER IS TO BE DILIGENTLY I� <br /> �URSU6D TO COh+PLE170N. THIS PERt•1R tdAY BE CANCFLLED 6Y THE C[TY UPON ANY STOPPAGE OF WORK ON TNIS PROJECi OVER 90 DAYS DURAT70N. I <br />