Laserfiche WebLink
AppLcutian Por / <br /> �� PiJBLlC '�IVORKS PERMIT Date��z��8 <br /> PUBLIC WORKS DEPARTMENT � <br /> Public Works Permit a c.� <br /> 3200 Cedar Sireet <br /> Everett,WA 58201 259-8810 <br /> Builtlina Permit k SA91 fl <br /> il'PEORPRINTONLY�� P(���'�N(; �iT 2 ], ZQd�NI1SOd Ol public'NorksFeeS 22..1r <br /> v <br /> LARSSON BERT 5805 HIGHIdAY PL EVGRETT 98203 425-290-1164 <br /> Owner Mailing Address Crt <br /> Y 2iP Phone <br /> Applicant Mailing Address Cit <br /> Y ZiP Phone <br /> Describe Proposed Work NEW HOUSE <br /> � <br /> !:.'ll_L y,Sv".UO • <br /> 64 00 ��A <br /> ,:i ��,. r♦ <br /> rF�;� cU.r,O <br /> PROJECT ADDRESS(if known) 1001 39TH ST . ,, <br /> Attach four(4)copies ol plans for proposed work-Draw to sc�le and nole the following if applicable: - � � � -��� � <br /> 'Property Lines •Outline and dimensions o(all existing and proposed strucWres on the lot •Existin9�pnd�proposed�utilities � <br /> •Centedine of sireet •Indicate Norih •Show any pmposed grading changes •Show measurements- - e� <br /> DO NOT WRITE BELOW THIS LINE --- •- ♦ <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspection shall be made 24 hours in advance - phone 259-8810.- <br /> 2. All work shall be performed in accordance with this permit and current City'of Everett Design and O <br /> Construction Standards and Specifications. _. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> �', J���IoPe� s���tl P�,,;de a, P�,,cd V�;�i.e -�'n �ro✓nd a��, �h.e, n.�doF � <br /> 3Gth St . G�S��n fa he ��ro�ed ra� �l,�e. P� OePar��m�„�-� � <br /> `J, �xtP.vd a'dese�,,.er, <br /> �.�.+�„+�.++, ;� �i� �.�h;,,d -b-,� f'�P�,'� �, a. <br /> �� ���. ���� <br /> Co . Ufg�r ge:'v�ce �v�o�r+ Fcc�era I ro be rtwted dcwn 39� s�e.t <br /> KO�J �✓ic� �11a. �� f'c5{xrP� � '�'ln¢. 52��r�t,c.f.,�on of � dc����nrM•�, <br /> 7, �rav�de �tre. P,�tac4,�on -l�o� ��e. �ra�eacd hovsG �s �.,irzd � <br /> �+e �� 1� ��vY, Ma�'sHull . <br /> � <br /> ACKNOWLEDGE�v1ENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harmless <br /> 7/�/�g the Cily of Everett from any and all claims for damages,costs,expenses,or <br /> Approved Co999simction � p o causes of action that may arise because of installation and maintenance of <br /> � � their,�provementorotherright-o4wayuseheretoappliedtorandfunheragmes <br /> /� � to remove same upon notice from ihe City and to replace public property <br /> I ��\ � l'� ��:- /D—/p _ 0 � damagedthereby. <br /> FINAL INSPECTION Oate <br /> Approved as Consimcted <br />. Signature of plicant '� <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLEfION.THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE Of WORK ON THIS PROJECT OVER 99 DAYS DURATION. <br />