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qpplicaticn For � <br /> � `��UBLIC WORKS PERMIT oate_ 7/3/97 <br /> PUBiIC N/ORKS _PARTMENT Public Wo•ks Permit q �L�L� <br /> 3200 Ceda�Street <br /> Everett,WA 98707 259-8810 <br /> MAR 2 2 q99 BuildingPermita 55R90 <br /> �r^ ?4STING <br /> TYPE OR PRINT ONLY �� Public Works Fee$� _ _ <br /> WARBIS CONSTRUCTION 10832 WILLOW RD LK STEVENS 9A258 356-7767 <br /> Owner Mailing Address City Zip Phone <br /> REINCKE 753-5923 <br /> Applicant Mailing Address City Zip Phone � <br /> Describe Proposed Work _ NEW HOUSE - SASIC 1237 � <br /> � <br /> _ <br /> PROJECT ADDRESS (if known) � �V �� � "1 J� �G LOT 2 SHORT PLAT 7- � <br /> A:tach four(4)copies of plans for proposed worn-Draw�o scale and note ihe following iF applica6le: �/� <br /> •Property Lines •Outline and dimensions of oil existing and proposed stmcWres on the lot •Existing�❑gd��p p ;.e tili i s ( ] <br /> •Centerline of street •Indicate NoAh •Show any proposed grading changes •Show measurer nts` $1 ���1�1 " <br /> �. � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: # 55f�� � <br /> 1. All calls for inspection shall be made 24 hours in advance- phone 259-SS���Ih'G 817.50 <br /> 2.All work shall be performed in accordance with this permit and current Ci���tt[�s� and <br /> Construction Standards and Specifications. Mt�HANICAL 60.00 <br /> 3. ;:�II Location Underground Service 48 hrs. before you dig. TOLL FREE ���-BOb-�4-5555. ` <br /> UkIVtWAY ^c0.00 r <br /> FLAN CHECY, 56.86 ♦,/'� <br /> N 9475 r�� <br /> WATEk 650.00 �' <br /> N 31210 � <br /> SEWER 70.00 <br /> UTILITY UEV <br /> 1296.00 <br /> l"OTAL 3072.88 <br /> CHEK 3072.B8 M <br /> A OF1375 <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> � ////� ���%� The undersigned owner/applicant hereby agrees to hold antl save harmless <br /> 9 /��� the City of Everett from any and all claims for damages, costs,expenses,or <br /> A proved for Con ction Dat causes of action ihat may arise because of installation and maintenance of <br /> / theimprovementorotherright-ol-wayuseheretoappliedfo�andfurtheragrees <br /> !a o remove same upo � e from the City and to replace public property <br /> - - � .v �0 dam ih y. <br /> FI INSPEC N ate � <br /> Approved as Constmcted I'i <br /> O � <br /> �gna ure of Applicant Date <br /> / <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURSUED TO - <br /> COMPLEfION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />� <br />