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/ <br />Date z ��2 <br />Applicalion For <br />PUBLIC WORKS PERIVII7 <br />Print or Type Only <br />Pupiic Work•. Pormll s <br />em9 oeut+ 36017 __ <br />Public Wo�ks Fee s <br />Tolal Fea <br />Less AppL Fee PaiC S <br />Balance Oue S <br />Sheraz R^mani 9324 - 7th Ave SE �verett, WA 98208 348-1249 <br />Owner Mai{ing Address City Zip Phone <br />Permabilt 16521 Hiwv 99 LvnnwooP, WA 96037 743-1555 <br />Applicani Mailing Address City Zip Phone <br />Jescrib� Proposed Work _��onstruct pol:. huildiny for vehicle storage <br />Project Address (if known) 9324 - 7th Ave SE <br />Altach four (4) copies of plans for proposed wo�R - Draw to �cale and note the tollow <br />• Property Lines <br />• Outline and dimensions of all existing and <br />proposed structures on the lot <br />• Existing and proposed utilities <br />• Centeri <br />• Indicate <br />• Show a <br />• Show R <br />UO NOT WRITE BELOW THIS LII <br />�N{TIAL INSPECTION <br />KIHK BROOKS <br />y-/-9� <br />DATE <br />PERMITCONDITIONS �.� � i <br />1. All calls for inspection shall be made 24 hrs. in advance - phone 259$1 i i-! "' �- L�'�� j" ��`' ��'' <br />2. All work shall be performed in accordance with this permit and wrrent C ~ '- -� <br />StandardsandSpecifications �%/�•��'-, f ` ���� � '��� <br />3. Call Location Underground Servlce 48 hrs �efore you dig. TOLL FREE 1 r� <br />N <br />��-� w�-�- P�� /ri�,����0 <br />� <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Conslructed <br />�A�I�F'UBLIC WORKS DEPARTMENT <br />3200 Cedar Sireet <br />Everett, WA 98201 <br />Phonr.: 'S9•8810 <br />� <br />5� �-92 ✓ <br />ACKNOWLEDGEMENT OF CQNDITIONS <br />;W <br />H <br />� <br />The undarsigned owner/applicant hereby agrees to hold and save harm- <br />less the City of Everetl trom any and all claims for damages. costs, <br />^zp.:nses. e• causes ot action ihat may arise because of installation <br />anrl m:�intenance of the improvement or other right-of•way use hereto <br />ap�lied for and further agrees to remove same upon notice from the <br />City and to replace public property damaged thereby. <br />� S grature of Applicant Date <br />V ORK AUTHOAi7F.D BY THIS PERMf( MUST BE STARTED WITHIN <br />130 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />Be D�LIGE�JI'LY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCEL�ED BY THE CITY UPON ANY STOPPAGE OF WOHK ON THIS <br />PROJECT OVER 90 JAYS DURATION. <br />