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_ . "�3��fING ' « � �Q�r� <br /> AppGcationFo"r` ��. Dale 1�31/96 � <br /> � PUBLIC WORKS PERMIT C'���_ <br /> PUBI.IC 4�ORKS DEPARTMENT Public Works Permit N _ <br /> 32�0 Cedar Street <br /> Everett,VpA 98201 259-8810 Building Permit ri_SOa 5�--'-- <br /> r� i,l � <br /> �'�� c� n In , <br /> �_ �. i i C� f i G. r [i n C' .- <br /> � Public Works Fee 5 Lk. <br /> TYPE OR PRINT ONLY "� r.i ci c� �� c� Q �� � �=� `� <br /> � �G v .1 � b:� M � � � �. <br /> � *= "' 980'i2 316-0261 /�, <br /> 18913 BOTHELL ;�VT HWY B�Tx�' <br /> PtETCO HOPIES LLC - ,� Z�P Phone � � ' <br /> Owner Mailing Addr� �, o �'-' -- �1 ���Y � '" <br /> Cr. 3 �� U W O L�l Ci G] <br /> m o c� ci .i �: ? � `.. <br /> \ ne� -u'iY� �' iYr' � ; o3ua. S -- <br /> Mailing Addr s1 City <br /> Zip Phone �+�' <br /> ApplicaN <br /> NEW HOUSE - BASIC 1133 � <br /> Describe Proposed Work �— ` <br /> I— <br /> �♦^ <br /> VJ <br /> 5408 13TH AVE W LOT 21 PIERRILL CRK PH 4 � <br /> PROJECT ADDRESS(if known) 0 <br /> qttach four(4)copies of plans for proposed work-Draw to scale and note ihe following it applicable: <br /> •Pmperty Lines •Outline and dimensions of all existing and propos�d stmctures on the lot •Ezisting and proposed utilities � <br /> •Centedine of street •Indicate North 'Show any proposed grading changes 'Show measurements <br /> DO NOT�NRITE BELOW THIS LINE � <br /> PERMIT CONGITIONS: � <br /> 1.All calls for inspection shall be made 24 hours in advance-pY�one 259-8810. <br /> 2. All work shall be performed in accordance with this permit and current City of Everett Design and <br /> Construction Standards and Specifications. H <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> �, ({z8p vity �treets ctean at ali times. � <br /> 5. Curb gu:ter and sidewnil� in the plat ace new and undamaged, any dacnege therek � <br /> rhall Ue repixced at the discretim► of the PuMOVe�°yk the Public Works 1nsQector, <br /> �, Any change in the driveway cut muat t� �p Y <br /> width :�t prop iine limited ta existing apron �vidth <br /> 7. Adjuet �vater boxas to grade st end oF construction. <br /> 8, Urive�vaVe shell be completely cured befnre driving on them. <br /> 9. Rooftop drainage shnll bo di6chargod to tha lots infiltration trencl� as per ttie <br /> "Residential RooF Dawnapout Syatem" detail and as per the slzing and locatio�i <br /> inforin�tion on the lot's siYe plan. Any change ln the infiitration trench must 6e <br /> approved by the Pnbtic Wor1cR Inspector• Cal1 f�x inspection prior to covering <br /> ���'�� ACKNOWLEDGEMENT OF CONDITIONS <br /> ' \/ � The undersigned owner/applicant here6y agrees to holdc�nds e%Pe seseor <br /> 7 � ihe Ciry ot Everett from any and all claims for damages, <br /> causes of action lhal may arise 6ecause of installalion and maintenance of <br /> ate theimpmvementorotherrighl-of-wayuseheretoappliedforandfuriheragrees <br /> Approved for Conshuction � to remcve s3me upon notice trom �he City and to replace public property <br /> C� damaged thereby. <br /> (� ��- .�__ c .w .yc <br /> ��/ Date <br /> FINALINSPECTION �_ � _ . <br /> Approved as Constmcted ate <br /> Si naWr Ap lican <br /> COMPLETIph RIHIS PERMIT MAY BE CANCEI ED BYTHE CITYIUPON ANY S�TOPPA�E C�WORK ON THIS PROJEC 0[R 90 DA SEDUIRATEONLY PUPSUED TO <br />