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Application For / <br /> � PUBUC WORaCS PERMIT Date 1/14/97 <br /> PUBLIC NIORKS DEPARTMENT Public Works Permit# � O <br /> 3200 Cedar Street <br /> Everett,WA 98201 259-8870 <br /> Building Permit k 5_39'�R <br /> TYPE OR PRINT ONLY �� POSTI N G FEB 1 7 199�_ public Works Fee$_�(J� <br /> AZURE CONSTRUCTION INC 10423 136TH NE KIRKLAND 98034 <br /> Owner Mailing Address City Zip Phone <br /> DALE LLOYD 821-4756 <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work NEW HOUSE — S � <br /> ��� < �����: ��.. <br /> JZ� _- /?7 i1;�53�:�4 i„�,. <br /> / � <br /> N00'�'S"S6 ♦A <br /> °�CS 'i^,'�^._" V/ <br /> PROJECT ADDRESS(if known) 10423 7TH avF S F. T.(1�Q '���� Q9' �" � <br /> �r� � 4bLl.]( <br /> Atlach four(4)copies of plans for proposed work-Draw to scale and note the followin�If applicable: �y.�;;},: ��; _:_-, O <br /> •Property Lines •Outline and dimensions of all existing and proposed structures on the lot •Existing and propoga4d.utilities�-.� ,��; <br /> •Centedine of sireet •Indicate North •Show any proposed grading changes •Show measuremenis ri`��,r�z�qj� � <br /> DO NOT WRITE BELOW THIS LINE '-'" ' `'"'` <br /> PERMIT CONDITIONS: °� '���`' ' `9O'�� � <br /> .�;.,,- . �,,'n.�;^ <br /> 1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. �,__�.,- =,��n� =^ O <br /> 2. All work shall be performed in accordance with this permit and current Gity of Everett De"sign antt <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> v♦' <br /> �� E�CC�) l'lIV srrccls cic;ui al all liwrs. O <br /> ' Curb gntte:r and sidewalli iu �l�e plal :ur u:w� au�l nndamaged, any dauiag; �liertto ;hall be repinad at �h � <br /> discreiimi oi lli� Public �G'mk� hispec�or. <br /> r� ,1w chancc in the dm�zway cut mu;t be approveJ by the P1U Lispcctor, width at prop Gne linuted to <br /> �sisling apron widtL. <br /> ' ldjust watcr boxes Io grade at cnd ol'conshvction. <br /> • D�iv�ways st�all bz compl�teh� curcd bc�ore dtivinr, on tliem. <br /> Ronliop rlr:iina��e �ir.dl hr di�ch:irged le Ihe stonn drain��.e shib pro��drrt ,d the front of ILr lot. <br /> ! (i�� <br /> ' ACKNOWLEDGEMENT OF CONDITIONS <br /> �� � � The undersigned owner/applicant hereby a9rees to hold and save ha�mless <br /> the City of Everett trom any and all claims for damages,costs,expenses,or <br /> App oved for Conslruction Dat causes of action ihat may arise because of installation and maintenance of <br /> � ihe improvement or other right-of-way use hereto applied tor and further agrees <br /> //�, s to remove same upon notice Irom the Ciry and to replace public property <br /> �,K w 6•�3 / � damaged ihereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed � �� � � `� _Q � <br /> Signa ure of Applicant Date <br /> WORK AUTHORIZED BY T41S PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLEfION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />