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,�:n..� <br /> N ruonr.vmrxs vermn. — 'I <br /> � � � Date 5_4_9�- �36581 _ <br /> Gia9 Deo <br /> p �' � qppiicabon For _ i <br /> � � N �UBL�C WORKS PERMIT P"°"""°'"'"` S <br /> toial Fee <br /> H '� LcssAppl.FcePaid $ — I <br /> K y � o.,i,���o�� 5 . <br /> '° y � Prinl or Type Only ' <br /> F i <br /> c, z <br /> [*1 H � — I <br /> Housing Authority of Everett 1401 Poolar Everett WA 98201 �SB-9999 <br /> � ��q O Mailing F�ddress City Zip Phone , � <br /> � , n Owner <br /> z � � 259-3161 � <br /> '� z Dykeman Arch. 1602 Hewitt #400 Everett 98201 phone <br /> O tn y Applicant <br /> Mailing Atldress ���Y Z�p ' <br /> O H <br /> (1 O N <br /> 3C _aa:�-:..., r9Mcf1 <br /> t� � M Describe Proposr.c Wark Vecti6 ' -- <br /> � H Vl — <br /> H O tn �� <br /> _�---� <br /> — — � <br /> Project Address�if knownl <br /> 2605 - 15th St. � � <br /> � <br /> Attach four 1•7)copies of plans lor proposeJ work� Draw lo scale and note ihe following as applicable: � <br /> • Property Lines • C�niedine ol streel <br />� O Indica�e North <br /> O Outline and dimensions of all existing and � ghov;any proposed yradin� chan9es <br /> propOSBd S�fuC�ureS on�he lot � Shovi me25Urements � <br /> • Existing and proposed ulilities <br /> � DO NOT WRITE BELO�N THIS LINE � <br /> j1��- PERMITCONDITIONS �\ � <br /> = � 1,All calls lor inspection shall be made 24 hrs.in advance-phone 259•8810. <br /> � 2.FII work shall be pedormed in accordance�vilh this permit and current City of Everett Design and Gonstruction ♦ <br /> Standards and Specilications ' � <br /> � 3.Call Location Underc�round Service A8 hrs.betore you dig TOLL PReE NUMBER 1•S00•424•5555. �� <br /> d��' � <br /> ...,o� � �I <br /> ; , ;. <br /> � �;' _ � <br /> , li <br /> I o� � <br /> 1�•`°' � <br /> �„O 8 � <br /> � ��,� � ACKNOWLEDG[61ENTOFCONDITIONS <br /> � � 7he undersigned ownedapplicant hereby a9rees lo hold and sav.�narm� ' <br /> _ less the Cdy ol Everelt Irom any and all claims tor tlamages, :osls, � <br /> � e�per,scs. or causes of aclion that may arise because of ins�allatio^ <br /> �O°t�' and maintenance o� Ihe improvement or olher riqhbol-way use hereto <br /> applieA lor and further a9rees to remove same upon notice Irom the <br /> Approved for Construction ��« City and to replace puulic property damaged thereby. <br /> FINAL INSPECTION Date Date <br /> Signa�ure of Applicant , <br /> Approved as Constructed i <br /> WORK AUTIIORIZED BY THIS PEHMIT MUST BE STARTLD \NITHI <br /> �� PUBLIC WORKS DEPAfiTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> i_ � 3200 Cedar Slreet BE DILICaENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE I <br /> �� Ever?iL WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF N'CRK ON THIS <br /> Phone:259��U1J PROJECT OVER 90 DAYS DURATION. <br /> I <br />