Laserfiche WebLink
Date�{q�G i <br /> 1✓ - Public Works Permlt< as/��� <br /> Application For BiEg.Dept R ���- _ <br /> PUBLl� WORKS PERMIT �� Publ¢YlorkSFea <br />� _p�_ Tolnl Fee $ <br /> q' <br /> Gless Appt Fee Pa�ia �_ <br /> Print orType Only TO i'OSTING �-� � y � o o c �'a°se2ve � §��^S��_ <br /> d <br /> ra mc- oo to 0 00 � <br /> � o r ca .-+ +�a r.� r'� r� n U <br /> ' �O a} ei sT M —I M� �J IfJ <br /> I !�-.l e�.� �o�u�s I hc � � "� 5►3�u� '" .,_; <br /> Owner MaiVino Adtlress City o:� N 2ip m ,- ri� iPhone> <br /> \ y' G_' 3 p Ci I�i fi-' Ll ` <br /> I r.� ocotaxmx oi.�ivwuc� �J '. <br /> oi onroc� nc� -2+ oro � a� LLi N <br /> \ O J J W J ir_ iY. � ¢ O W <br /> I <br /> N�? 3C ul 0. �_ W [n CS 1 3 St t�) [f) f_l <br /> I Applicant Mailing Address City Zip Phone ' <br /> Describe Proposed Work I�t�✓ "vV�. <br /> � Project Address(i( known) ��03 � ��"WI ��� �.rT�i 77 `'I vl�. � <br /> � <br /> Attach four(4) copies of plans for proposed work- Draw lo scale and note �he following as applica6le: � <br /> • Properry Lines • Centerline of street /w <br /> • Outline and dimensions of all existing and • Indicate North V, <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS <br /> 1.All calls tor inspection shall be made 24 hrs.in advance-phone 259•8810. � <br /> 2.All work shall be pedormed in accordance�vith this permit and cwrent City ci Everelt Design and Consiruction <br /> Standards and Specitications. <br /> 3.Call Location Underground Service 48 hrs.betore you dig.TOLL FREE NUMHER 1•S00•424-5555. � <br /> d. �uuI1�N cJtuinuye slioll be disi:hilry�v to ihe Iois sionn �irain siuL locuied ul ihe fruni <br /> OF tf1P. IOt. � <br /> S. Keep city streeis clean at all times. <br /> 6. Curb c7utter and sidewalk in the plat are new aiid undamaged, any damage thereto <br /> shail �e replaced ai fhe discrelion o( the Public Works Inspector. � <br /> 7. Any change in the driveway cut must be approved by the ?ub6c Works Inspector, <br /> wicllfi al prop line limited lo existing apron widfh. Driveway may taper c�radually to //\ <br /> meel garr�ge door entrance (for an approved 3 car S�arage?. N� <br /> f3. Acljusf waler boxes to c�rade at end of consirucfion. /'� <br /> 9. Uciveways shall be completely cured bef�re driving on them. V <br /> 10. �he residence on this lol is required fo insfall a Fire Sprinkler Syslem. Thc: S{�rinkler A <br /> system shall be installed in accordance with the items listed in Saftvfirst fire S�stems �� <br /> le�lar c;�1ed 11/30/9d. Spexificaily, a 1" rninimum size water meter shali be inslalled: u <br /> 1 I/2" r•.'n;,num size pipe from the me:ter to tlie house snall bc used: and all supply <br /> waler pipiiu� 10 homes should be run in copper pipeA�Rn1��o��F���FPB�LU�iDI���N��'�n�� <br /> (nf dPtOl�S. 7he undersigned owner/applicanl hereby agrees to hold and save harm- <br /> �� less the Cily of Everett trom any and all claims for damages, cosls, <br /> /� ��G/' _ ���/�r expenses, or causes ol action that may arise because of installation <br /> � ��%oo. � and maintenance ot the improvement or other right-ohway use hereto <br /> applied for and iurther agrees lo remoae same upon notice from ine <br /> Approved for Construct� rr —�Date Cily and to replace putlic property dainaged ihereby. <br /> /'Li" `����—� ��'�` l% � /f.,�� R 1 .� <br /> FINALINSPECTION Dale ��-/-��+ � � ��"+ �f�� /Date/`S <br /> Approved as Constructed Si�nature of Applicant <br /> PUBLIC WORKS DEPARTMENT WORK AUTHORIZED 0Y THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CedarStreet 180 DA1'S OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everelt,WA 98207 BE DILIGENTt.Y Pi1RSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:559�8810 CANCELLED BY TH@ CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PFOJECT OVER 90 GAYS DURATION. <br />