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. oete 4'�' Q9 � <br /> ,1ppYc•noo F« , <br /> PUBLIC WOI�KS PERMIT p�y��y�orksPermilN <br /> PUBLIC WORKS DEPARTMENT <br /> 3200 Cedar Street <br /> Everett,WA 98201 (425)257-8810 Building Pertnit M —T <br /> TYPE OR PRINT ONLY Public Works Fee S Z� �A1�ST <br /> ��l' <br /> /�l�f .T/�'I .�.�UFF� SO/3 Z3� /� �!!• �P�O 3 4ZS 3S3-0367 <br /> Owner Maili�9 Addresa cih' zip Phone <br /> P�/II� l�Ph/ ld111 ,N.f�Ir�KNl6 /�l5 SE 3�' QiEi'!iu'!l Qf�»G 4ZJ=JZ Z-O//� <br /> ���� • Matling Address Ciry �P �0^e <br /> �esoribe Froposed Work �,vsr.AfG loE�.f�YE Ffl� �•�'lr W <br /> A�y�{� �n 2.�Pi�i•d SS^�rF-+�f��1D.QiA', k/u/l.d U.t•F TO � <br /> E:v�-�e �r� � ,�,v /f ,�o�r,e� N <br /> PiiOJECTADDRESS (if known) �d�� Z3� � O <br /> Atfech four(4)copies plans fa P��S��90�-Drew to scale ard note the fdbwing it epplkable: � <br /> •Properry Unes •Outline ard dimensions ot ell edsting and proposed stnictures on the bt •Existlng and proposed utilflfes <br /> •Centerline of str:.et •Irdkate North •Show enY P�O�fng chenges •Staw measuremeMa � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS: <br /> 1. All calis for inspection shall be made 24 hours in advance- phone (425) 257-8810 <br /> 2. All work shall be peAormed in accordance with this permit and current City of Everett Casign and � <br /> Construction Stendards and Specifications. it � <br /> 3. Call Location Underground Service 48 hrs. before you dig.TOLL FREE NUMBER 1-900-424-5555 � <br /> �l ..�,- �� s �-� 3 � 9 �,r s rd � -z - 3 �� , '0' <br /> � � �-�� a <br /> ACNNOWLEDf3EMENT OF CUNDITIONS <br /> The uncleMG^ed w+�br/appNcent hxebY�rets to h01d and eave hanNeas <br /> V�e Gly of Everetl from eny and eH deirns Aor drnepas,coals�exVerees�a <br /> ceusea ot nctlon tl�et msY eriae bxeuse of kreteMeYon erd m�d tl�e <br /> rove or iuc e e �p��nt a dher dpMal-wey we hsrab aPWbd � and IurNx aprsee b <br /> rertave aame Irom the CIIY end b D�MoPehY d�- <br /> !� ' /O �oL +`l� `J Me <br /> FINAL INSPECTION Date � r� ���� <br /> ppproved as Constructed <br /> OOI�PLEf10N•hNSPERMtTMA�iCANCB.Lm�CffYUPONMIY370PP1H3E�TW0ii(� PAO�ECTOUEA60WYY90llIA11011YR1R�1�T0 <br />