11221 SILVER LAKE RD 2018-01-01 MF Import

y p rr�aY e 2 �ss ZZ�- Date 4%5/9� lo fQ�T��U v�oi�cwo�wsve,mn. ` .�� 9'$ Applieation For eieo oen�.• 4 �� PUBLIC WORKS PERMIT Pubi¢WoiksFee Total Fee s Less ROD��Fee PaiC s Baianca oue s �'s C'� Print or Type Only d02 �3ZZ�o//.9� / City of Everett 3101 Cedar St 98:i)1 259-8849 Owner Mailing Atldress Ciry Zip Phone John Noble Applicant Mailing Adtlress Cily Zip Phone Describe Proposed Work Fire Station !17 W Prolect Addrest nf known� 11221 Silver Lk Rd � Altach four(�3}copies ol plans lor proposed work- Draw to sr.ale antl note the tollowing as applicable: � • Proper�y Lines • Centerline ol sireet /� • Outline and dimen5ions ot all exisling and • Indicate Norih V� proposed siructures on the lot • Show any proposed grading changns • Existing and proposed utilities • Show measurements M W DO NOT WRITE BELOW THIS LINE O PERMIT CONDITIONS 1.All cails for inspection shall be made 24 hrs.in ativance•phone 259•8810. � 2.All work shall be peAormed in accordance with this permit and current Cily of Everett�esign and Construction Standards and Specifications. � 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800�424•5555. � /. N/Cy/'� fo OC dohE JOP.�^ ��?nS !'i��i-p✓G'f O UJ7 .s/ �f_�S- � � O a � � �� C �;� MAY 1 ? 199� ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agreec to hold and save harm• — less ihe City of Everetl Irom any and all claims for damages, cosis, CITY OP � 2�4 oi causes of action that may arise because of instauation � / �iPhaintenance of the improvement or other right�ohway use hereto ��0-0-1�2 BUilding ��or and further agrees to remove same upon notice irom the Appro�r dion �a�e City and to replace public property damaged thereby. F A INSPECTION ^ ��/ �Date ��" "� � ��1� �� qpprovetl as Constructed Signature of ApplicaM� Date WORK AUTHORIZED BY THIS PERMIT MUST BE STAFTED WITHIN PUBLIC WORKS DEPARTMENT 7g0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO ��r� 3200CedarStreet BE DILIGENTLY PURSUED TO COMPLETION. THIS PERM�T MAY 8E Everet6 WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS Phone:259-8810 pROJECT OVER 90 DAYS DURATION. .