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<br />'.�.,�t: ApplicationFor ___ _ _
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<br />'i.; -- Descri6e Proposed Work .�A -�— �
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<br />.N„r-^f . �rolect Address(if known) �
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<br />'��r���,-� �Itach four(4)copies of plans tor proposed wark- Draw to scale and note lhe following as applicable: �
<br /> h • Property Lincs � Cente�line of slreet +�*t
<br />��*i r� 4• :ndicate Norlh �� �t£�� p
<br />�� - • Outline and dimensions o1 all ezisting and
<br />� y � = proposed structure5 on the lot • Sho�.v any proposed grading changes
<br />� �t�- ��, Y Exisling and proposed utili�ies • Show measurements ` � � i��
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<br /> j�� I � DO NOT WRITE BELOW THI� L'Nt � �",��f'1f�1"'i� �k �
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<br /> � i � � PERMIT CONDITIONS � ��
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<br /> �t�E y ;_i 1. All ca!Is for'.nsppction sY.all be made 24 hrs. in advance- phone 259•881 5. �- ��.q �
<br />'{b J k'. 2. All h•xh shail br. performad in accordance with�his permil and current City nt Everett Design and Construction � ���j t
<br />'� Standards and Specifications. ,.
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<br /> ir'�t,, . 3. Call Lo:ation Underground Servic?48 h�,. betore you dig.TO.'..l FREE NUMBER 1-800•424•5555. iec� r; t``I' a
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<br /> f��;� '.:jl , ACKNOWLEDGEMENT OF CONDITIONS
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<br />,� �.�t;�;, ��. � The undersigned owner.�applicanl hereby ac�rees to hold and save harm-
<br />' S�-'"' ` '� less �he City ol Everett from any and all claims tor damages, costs,
<br /> f`' �-� � expenses, or causes of aclion that may arise becausr, of installation
<br /> �x�� Q�� /� /�/9 i and maintenance cl Ihe improvement or other right-o(-�vay use hereto
<br /> �'U/' � ,(ih /�=z appiied lor and luriner agrees to remove same upon notice irom ihe
<br /> Approved for Cbn truction � �a�� City and to replace pub�.c property damaged thereby.
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<br /> FINA�.�FNSP ION Date
<br /> Approved as Consiructed SignaWr�e of F li ant
<br /> WORK AUTHORIZED Bl' THIS PERPAIT MUST BE STARTED WITHIN
<br /> everett PUBLIC WORKS DEPARTMENT 1F30 DAYS OF DATE PERMIT IS ISSUED AND 7HEREAFTEF IS TO
<br /> � 3200 Cedar Street BE DILIGENTLY PURSUED ?0 COMPLE710N. �fHIS PERMIT MAY BE
<br /> Everett,WA 98201 I CAIJCELIED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS
<br /> Phone� 259-BB15 PRO.IFCi OVER 00 DAYS DURATION.
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