9430 21ST DR SE 2016-01-01 MF Import

. �L. � �•zb•5 Apq�Cation For � PUBLIC WORK� PERII�:T PUBLIC WO�CS DEPARTMENT � � 8 .xyy� 3200 �edar Street �n pOSTING �•��erett,WA�201 259-8810 TYPE OR PRINT ONLY g � g$p� S � g g£ r. .+o.p t€1 h'p�.M�'�i � � N N M� M� N f JOHN DEG.200T 5724 87TH AV�NE EVEREi� iA205� Describe Proposed Work NE[� HOUSE `�� PROJECT ADDRESS(ifknown) 9430 215T DR SE oate 4/15/96 Public Works PertnR N Building Pertnit 8 51440 Public Works Feo S �� Phone Phone Attach Icur (4) copies ot p�ans for proposed work • Draw to scale and note the tollowing "applicabie: •property Lines "Outline and dimensions of all existing and proposed structures on the �ot •6cisting and proposed utilities •Centedine of street •Indicate North •Show a�y proposed grading changes 'Show measurements PERMIT CONDITIONS: 1. All calis for inspection shall be made 24 hours in advance - phone 259-8810. 2. All �aork shall be performed in accordance with this permit and current City of Everett Qesign ar�� C.��,struction Standards and Specifications. 3. Ca;t i:.ocation Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-56[b. a. Provide a of�P street parking stnlis. t7 ACKNOW�EDGEMENT OF CONDITIONS The undersigned ow�ier/upplicant hereby aprees to hoid ard save harmless the City of Everett from eny :md all claims for damages, costs. expxmes, or causes of actbn that may arise hecause of Installetbn and maintenance of �+PProvea�u�a.uinuu�uvi� •••••,• U1BlmproVe111entOrotheffl9h�-o}-WeyU38hef8to0ppliBdlOrandiURhefe9fees to remove seme upon nodce fiom the Ciry and to replece publk prooertY �'�yj 2�_. 3 -2 �_ g' �'"e9�,�. , F�NAL INSPECTION Date � � Approved •as Constructed ure o AppllceM Dete ' WORK AUTHORIZED BY THIS PERMIT MUST BE STAFifED WITHIN 1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILKiB1TLY PUHSUED TO COMPLEfION. THIS PERMR MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PHOJECT OVER 90 DAYS DUR11710N.