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. , . <br /> Date�11� TC PaSTING �u -4s �„����w��k�P�,�m�. SP ( ? � <br /> BldgDepi.•�`�� <br /> Application For „ <br /> � PUBLIC W(3RKS PERN�IT PuhlicWoikSFce <br /> Toi,�F�� 5 <br /> R <br /> p Less Appl Fee Pa�a $ <br /> CJ 1 <br /> [:� p O O O O G BY��"4ea�9 5 <br /> Print or Type Only � c�. o r� o i� o o , <br /> ¢ <br /> c� oiNoo .to 0 000� <br /> �,, o � m � �a «i ��� .�a � �n <br /> ,� 'S�+�,/�rooco <br /> �elec� +��te5 1,�� � � � � � — <br /> — Mailin Address p• �. t� City �a ^- a�Zi o a Phone <br /> Owner 9 �. � cY: 's c� r�r; r� w j- � � �� <br /> q p (p � 2 t� S � O W O 4r7 O U � <br /> �-.� p �-� p] (..1 p C.1 �^'� [:J h O 3 UJ W <br /> O J J W _I fi "v' � Q O W '- S 1 �, ; <br /> ��� Ye G] O_ X_ (a� G'� � YC :T 7t ffi i�1 C..] V <br /> Applicant Mailing Add�ess City Zip Phone � <br /> Describe Proposed Work ��P� ��� — — <br /> 1�1 � <br /> Project Address(il known) � [!J� I�� pr� .—. �°�'23 I�'l G� � <br /> Attach tour(41 copies of plans for proposed work- Draw to scale and note �he following as applicable: � <br /> • Proper�y Lines • Centerline of sUeel ♦A <br /> • Outline and dimensions of all existing and • Intlicate Norih V� <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existiny and proposed utilities • Show measuremenls qA <br /> W <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All cslls tor inspection shall be made 24 hrs.in advance-phone 259•8810. � <br /> 2.All work shall be pedormed in accordance with ihis permit and current City of Everett Design and Consiruction <br /> Standards and Speci'ica�ions. <br /> ��aR�RS�l9p�u,��5et��;���4A.h���§�!Pr�Yg�;�iTP44,€qF�5H4�MR�Pdr�P54�8-�.`�ted oi 1he tron � <br /> of the lot. <br /> 5. Kee�; city s�reels clean c�t aIl limes. f`y <br /> 6. C�rb guiler and sidewalk in the plat are new antl undamaged, any damoge thereto �� <br /> shall b� repluced ul ihe discretion of It�e Public Works Inspector. � <br /> J. My change in ihe driveway cut must be approved by the Public Works Inspector, <br /> r�icllh ui p�op line Iimiiecl lo existin,y apron widih. Driveway may taper c�radually fo � <br /> m�et garage door enirance (for an approved 3 car garage). <br /> �. Adjusf walei �oxes to yiucJc; a� end ol i:�mstruction. � <br /> 9. Driveways shall b� completely curr:d before driving on ihem. <br /> IO.The iesidence on ihis lut is re4uirr;d to inslali a fire Sprinkler Systern. The Sprinkler � <br /> s��tem shall be insYalled i� accordance with the items listed in Safiv/=ir.sf Pire S .vstems <br /> lelfer daled 11/30l9A. Spexifically, c� 1" minimum sizc: wuter meter shall be ins�alied: a � <br /> 1 I/2" minimum size pipe from the meter to the house shall be used; and all supply <br /> wuler pipiny lo homes should be run in copper pipe lo reciucc: I�ic.tion foss. See mem� <br /> fn( ��r���S. ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owneqapplicant herehy agreo�to hold and save harrm <br /> less Ihe City of Eve�etl Irom any and all clz'ms for damages. costs. <br /> expenses, or causes of action that may arise herause of installation <br /> ___/���� ' " ' C� � �� �� and maintenance ot ll�e imProvement or other right�obway use herelo <br /> applied for and turihei agrees to remove same upon notice fiom the <br /> Approved for��onstructi Date City and to replace public preperry damaged thereby. <br /> L� <br /> — /��/�s <br /> Q/�- _�� G-�r 3 � y� �,QF I�rr,�.ca �'1eA r �� �� 3 <br /> FINAL �NSPECTION Date (,J Dale <br /> Approved as Constructed Sign2ture of A�Plicant <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITFIIN <br /> �� PUBLICWORKSDEPARTMEN7 180 DAYS OF DATE PERMIT IS ISSUED AIJD THEREAFTER IS TG <br /> 3200CedarStreet fiE DILIGENTLI' PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> � Everett,WA 98201 Ci:NCELLED BY THE CITY UPON ANY STOPPAGE OF WORK OP!THIS <br /> Phone:259�8810 PRU.IECT OVER 90 DAYS DURATION. <br />