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_ ._ _ _ _ <br /> APPIic�tiunFO� P [ ��JC' V � IQQ� � <br /> �Cw���YF�7T PUB��� W���S ��� ae 1/3�/96 <br /> PUBUC WORKS�-0EPARTMENT Public Works Permit N _��030 � <br /> 3200 Cedar Sireet <br /> Everett:WA 98201 259-8810 <br /> c� Building Permit tl 58�-�i-6 <br /> r.:� — <br /> O C,-, G fJ C� C� G C�' G <br /> 1 ., G: O tr) r r'� ,ry 6 n. /J� <br /> il'PE OR PRINT ONLY ��. • � � P iblic Works Pee 5 � <br /> CJ ��i1 C G ai C I��� �-: C.i ��� —G./_L/ ____ <br /> vl C. U C (C� ii� <br /> �,; �� w �w +,� �i "� ;ii -. <br /> PtETCO HOMES LLC 18913 BOTHEI.L �P$RETT HWY ��BOT�ELL 98012 316-0261 --� <br /> i <br /> Owner Mailing Address \� p u 3i�� �, � � : Zip Phone � <br /> o- ncor� :i. .r: � �� �iin �, " i.i N � <br /> MARY MCCRARY �' � n ��� �, �� �� o r o 3 � ., � I <br /> �, a _i _� w o- 'v' n g o w � ;_ � <br /> Applicant Mailing Address City � Zip Phone ' <br /> . <br /> Describe Proposed Work NEW HOUSE - BASIC 1106 �� � <br /> r <br /> � <br /> PROJECT ADDRESS(if known) 5410 13TH AVE td LOT 22 MERRILL �RK PH 4 � � <br /> Atlach four(4)copies of plars for proposed work-Draw to scale and note the fo�lowing if applicable: . W <br /> •Property Lines •Outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities O <br /> •Centerliae of street •Indicate North •Sho��any proposed grading changes •Show measuremenis <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT COIJDITI�NS: � <br /> 1.All calls for inspection shall be made 24 hours in advance- phone 259-8810. <br /> 2.AII work sliall be pertormed i�accordance with this permit and current City of Everett Design and O <br /> Constniction S?andards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> �• F{eep city streets clean at all times. � <br /> 5. Curb guttee and side�vaik in the plat are ne�e and undsmaged, any damage theret � <br /> shail be repinced .�t the discretion of the Public Worka Inspector. � <br /> 6• Any change in the d�ivewap cut must bc+ a�proved by tho Puhlic Works Inepoctor, <br /> tvidth at prop line limited to �xlsting apron width <br /> '7• AdJust �vater boxes to graale at end cf cr�nsYruction. <br /> $. Deivawxys ehall be completely cured before driving on them. <br /> 9• Rooftop drainage a}iall be dlscharged to the lots intli±raHon trench ae pet the <br /> "Residen!ial Roof Do�mspout �qet�3m" deteii and as r�er the sizing and location <br /> informatlon on the lot's site plan. Any chflnge in the infiltratiun trench must b� <br /> approved UV khe Pu.blic Works SnsFector. <br /> �� <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> ti//C� „ /�/�� The undersigned owner/applicant hereby agrees to hold and save harmless <br /> //( �� the City of Everett from any and all claims for damages,cosis,expenses,or <br /> App oved for C sWc'on ate causes of actien ihat may arise because of installation and maintenance of <br /> � / the improvement or other right-of-way use hereto applied for and(udher agrees <br /> /�/ to remove same upon notice from ihe City and to replace public property <br /> /1 /,�Y �� 7-i/f� damagedthereby. � <br /> FINAL INSPECTIUN Date <br /> Approved as Constructed �^ <br /> \ <br /> Signature of Ap li� nt Date <br /> WORK HUTNORIZED BY THIS PERMIT MUST FE STP.RTED WITHIP�160 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS BE DILIGEfdTLY PURSUED TO <br /> COMPLETION.THIS PERMIT MAV BE CANCELLED 6Y THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />