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Application For � <br /> � PUBLIC WORKS PERMIT Date 7/31/98 _ <br /> PUBLIC WOflKS DEPARTMENT PuWic Works P9rtnR N / 0 27" <br /> 3200 Cedar Slreet <br /> Everett,WA 98201 259-NB10 Building Pertnit N 50h0y___ <br /> J <br /> TYPEORPRINTONLY TO POSTING SEP_-- PublicWorksFce$ Z0 �' <br /> ! <br /> HABITAT FOR HUMANITY PO BOX 1571 LYNNWOOD 98046 425-672-1628 <br /> Owner Mailing Address City Zip Phone <br /> CONTACT• JOHN SCHLATTER 425-356-3466 <br /> Applicant Mailing Address Cfly Zip Phone <br /> Describe Proposed Work NEW DUPLEX - BASIC 200i ■� / <br /> ` W � <br /> �� -ls-;a ��:lrr�� � <br /> E� JSb�I% � <br /> — C.'.�-1_U _U(J.I�V <br /> PROJECTADDl9ESS(ifknown) 1212 26TH �T (A & B) -�'�'=' '`•` " <br /> -c�_r 1.Zu.Gc � <br /> Attach four(4)copies of plans for proposed�vork-Draw to scale and note the follcwing if applicable: ::;iLHv �.�0 O <br /> •Property Lines •Outline and dimension�of all existing and proposed structures on the lot •Existing a�d;¢rQposed�itl_Ifpqs�(� <br /> 'Centerline of street •Indicate North 'Show any proposed grading changes •Show measurertieototi i;;< <.4.c.y � <br /> ,,. <br /> DO NOT WRITE BELOW THIS LINE ;;,?�;� ��;j.i;�: <br /> PERMIT CONDITIONS: , _;; , � Z I <br /> 1.All calls for inspection shall be made 24 hours in advance-phone 259-8810�{,:,� �, - � <br /> 2.Atl work shall be performed in accordance with this permit and current City:of 6verett Design and <br /> Construction Standards and Specifications. - ,-,T,;; ,q���,�_�< <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-4245555.,,_,.. ;:� <br /> i...e�.,_:-. <br /> ii 1:�Ic•tP�_ � <br /> `�• f�e�L�zce Sio%wal,E alo:,, fhc sovfh s�de <br />, a F 1�O�h .S'�: �¢r Clfy �4n danp�S_ (S�k�io�e X 4���iiGk) li <br /> .j. Sio�e-Se�e� �0 6c �hshaCCc� �oe�- e��f/ <br /> s¢4., da�d #�o/ �Goz � � 60¢. <br /> CDF. ShaLG be� [�s�o� jn !•t/. �-nar:.�c liieu� dr. <br /> �o • COnn�c� �"oo{ �o�P O�OWn,S�Grl�S '�o Side-SeWe✓: <br />�. <br /> ,� <br />� ' ACKNOWLEDGEMENTOFCONDRIONS <br /> � � � The undersigned ownedapplicant heieby agrees to hold and save hartnless <br /> � the City of Everatt from any and all ciaims tor damages,costs,expenses,or <br /> App e� or Co tion Date causes of action ihat may arise because of installatbn and maintenance of <br /> the improvement or other righbof-way use herato applied tor 3nd turther egrees <br /> � � � to remove same upon notice from the City and ro replace public property <br /> ���� _ , damagedthereby. <br /> ��-v� <br /> FINAL INSPECTION Date <br /> Appro��ed as Constructed �.L J <br /> , �.c��_ <br /> Sig of Applica Date <br /> WORK AUfHORIZED BY THIS PERMIT MUST BE SThRTED WITHIN 180 DAYS OF DAT E R IS ISSUED AND THEREAFTER IS TO BE DIIJGEMLY PUflSUED TO <br /> COMPLE'fI0W.1NIS PCnMIT MAY BE ChNCELLED BY THE CITY UPON ANY STOPPA F WORK ON THIS PROJECT OVER 90 DAYS OURATION. <br />