1510 49TH PL SW 2016-01-01 MF Import

�s.- - . ..._.._ _ I 0� ,...... �� Application For M / PUBLIC WORKS PERMIT �1e— � �-31-98 _ PUBLIC WORKS DEPARTMENT Pubik YVorks Pe ��M � Z 7� � 32��8�� 2 a z°°° ^� — To"�'6�r�cz59_�_ T -- Building Permk 8 t; 6006� .J fYPE OR PRINT ONLY �� oQ 0 0 0, o �o .�Pry,1��lic VZqrks F�S�____ � . <L'�OC� � OI!'1C) O (`� GOl C) �j O OCJ �p , f�)S� • • • • Ol �u :..� [.`elch's Conatruction 6322 76th ➢�':�iici 6n6`�om�sia�- �Ae�Bi ��-43`�9s��9 � f.� ^I 1 I Owner Malling Address f City Zlp ' � ,iPhone P r � . OwneT y o �p T � w � rc cc .�'—. S-( z � ¢ Applicant Mailing Address P 7 J W��YJS �¢ �w iZ11R��¢ � ~ Phone �� c:» (ai r� t cn u fL a -i sc U� � 3 �^ Describe proposed Work new liouse - IIasic 1230 _ � � � PROJECTADDRESS(ifknown) 1510 49th P1 St:� Lot 9 SP lli-97 � Attach four(4)copies of plans for proposed work-Draw to scale and note the following ii applicable: � � •Pmperty Lines. 'Outline and dimenslons of all ex(sting and proposed sWctures on the!ot •F�cisting and proposed utilities O 'Centerline of street •Indicate NoAh 'Show any proposed grading changes •Show measurements � 1 ..t.. DO NOT WRITE :.r.:'_OW THIS LINE PERMIT CONDITIONS: � 1.All calls for inspection shall be made 24 hours in advancP-phone 259-8810. 2.All work shaii be performed in accordance with this permit and current City of Everett Design and �. Construction Standards and Specifications. � 3. Call Location Underground Service 48 hrs. befure you dig. TOLL FREE NUMBER 1-800-4245555. � ,i �l • �WT '� YV n � �� h t � I�'�.�, An 'fY'�Ev�G I� f.. ) � G�.'E7,�C In Cc�'� �c�vl , � O a .; � ACKNOWLfDGEMENT OF CONDITIONS �� J �� `n� � /; �� The u�ersigned owner/applicant hereby agrees to hold and save hartnless V � y the C of Everett from an and all claims for damages,coste,expenses,w . Approned for Constru t n D te causes of action that may arise because o1 installation and mainten;3nce of ., the improvement or oMer right-of-way use Imreto applied for and tuRher agrees � to remove same upon notice fiom the City and to replace pudic qnpeity � l�_ ,ZS_�� amaged thereby. FINAL INSPECTION Date �� i Approved as Consiructed �• �� g g g Signa re of Applicant te , WORK AUTHORIZED BY THIS PERMIT MUST 8E STHHTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTEp IS TO CE�ILIGENTLY PURSUED TO COMPLEiION.THIS PERMR MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK OfV THIS PRQIECT OVER 90 DA1:S IXIHATION.