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� iplication For i. <br /> PUBLIG ��OR a� PER1�/113' Date 1-29-97 <br /> PUBLIG WORKS OEPARTMENT Pcblic Works Fermit# <br /> 3200 Cedar Sireet <br /> Everett,WA9A201 zss-eeio Buildin Perm:tk_. 54089 <br /> �'� �(ISTING `� � s �°s 9 <br /> TYPE OR PRINT ONLY Public Worics Fze 5 --�� '�- <br /> Kim Hende:son 915 6ist Ave SE Bczrett k'A. 98205 252-7226 <br /> Ocmer Mailing Address City Zip Phone <br /> Owr.er <br /> Applicant Mailing Address Ci!�,- Zip Phone <br /> Describe Proposed tNork repnsitioning office trailer <br /> � <br /> — �' �f <br /> � � <br /> -� � i.. <br /> g;. <br /> PROJECT ADDRESS (if known) 2415 40th St � ,ri <br /> Attach four(ay copies of plans for proposed work-�raw to scaie and note the following if applicable: � <br /> •Pr�perty�ini�s •Outlirn+and dimensions of all exisiing and pmposed sirucWres on the lot •Existing,^�d proposed utilities �;� <br /> •Centedine of street 'Indir,ate Norih •Show any proposed grading changes •Show measurert .�ts � , , <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERbSIT CONDITION£: � <br /> 1. All calls for in>pection 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 Ever�tt Design and <br /> Co�istruction Standards and Specifications. ' � <br /> 3. Call Location Underground Service 48 hr;. before you d?g. TOLL FREE NUMBER 1-80Q-424-5555. � � <br /> / �Vi=E�s o �vAy ; � `�` <br /> /� �` �y � <br /> ��.i R L _.' �f" ��� °�.TD`� i'�.[�¢,�: de�f_ id�. <br /> ((. WO�IKs PFiF6�� <br /> ''O� °i�efaVJl�Rsr �o ��7sfi"a.�� 3%`�i� s�:r�%ce !� <br /> '1,'�� �— ��� � C)J ' � � i <br /> fATc � �C� SCCiI�/" P�;i%�'I�f, <br /> - �7-.� . i i <br /> / <br /> — yo,eo. /9 99- 9¢ �. <br /> y�/U/ ir�in, C/qry� <br /> �� <br /> ACY.NOWI EDGEMENT�F CONDITIUNS � <br /> The undersigned owner/appiicant hereby agrees to ho!d and save hannlc.- �, <br /> ihe City of Everett 6om any and all cla�ms for damages,costs,ezpenses.ni 1. �� <br /> causes of action fhat may arise becausr,of installation and maintenancc ef <br /> c;- <br /> Approved for Construction Date I,� <br /> the improvement or other right-of-way use herelo applied for and further agrms <br /> to remove same upon nctice 'rom the City and to replace public prop�ity ��1i <br /> damayed thereby. <br /> FINAL INSFECTION Date <br /> Approved as Cons�ructed <br /> SignaWre of Applicant Date ; <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WIiHIN 180 D4YS OF DATE PERMIf IS ISSUED AND THEREAFTER IS TO BE DILIGEN7LY PURSUED TO I,-;;� <br /> COMPL'cTION.THIS PEP.MIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJEC70VER 90 DAYS DURATION. f <br /> t�`� <br /> �,.�, <br />