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� <br />TYPE (�R PRINT ONLY <br />ApDhca�ion Por <br />PUBLIC WO��KS �ERMIT <br />PUBL�C WORK^ DFPARTMENT <br />3200 Cedar �treet <br />Everett, WA 98201 258-8810 <br />i0 POSTING�_4 +�a, <br />D:�E_ —"_l�l <br />Pu61ic Works PermO M _��� �_ / <br />Bulltling Permit M _ 53Q, <br />/ Ai <br />Public Works Fee S L��v <br />SU'1MARK HOMES 2210 HRWITT AVE6210_ mrcncTT oa�n� 259-4200 <br />Owner Melling Address City Zip Phone <br />L:VID PIGGOT 259�4200 <br />Applicant Malling Adtlress City Zip Phone r <br />Describe Proposed Wurk NEW HOUSE — BASIC 1215 <br />;_o� s7^9 �- <br />PROJECT ADDRESS (if known) <br />Attech four (4) coples ol plens lor proposed work - Draw to scele and note the lollowing If appliceble: ME�`- $6f_�, �Y' <br />•Property Lines 'Oulllne end dimenslons of all e:isting end proposed slructuras on �he lot •Existing end p�M6d�utllltles 14 .�0 <br />•Centedine of etreet •Indicete �oAh •Show eny proposetl grading changes •Show measurements �' _: Tt'G����__ ��� ��)� <br />DO NOT WRITE BELOW THIS LINE W�`,-F �!;, "�; <br />PERMIT CONDITIONS: �lDD;'.790` <br />1. Atl calis for Inspection shall be made 24 hours in advance - phono 259-881D. �rWF,• ;:^., �-• <br />2. All work shatl be pertormed in accordance with this permit and current City of Evere�t Dqslgn and <br />Constructlon Standards and Speci(icatfons. �!"�"� � "^ ' <br />3. Call Location Underground Service 48 hrs, bofore you dig. TOLL FREE NUMBER :1-800-42A-6655. <br />I:rcp nh -hec�> rlean ai :dl inuc- <br />c1uL E�utl�� aud �idcw;dA iu Il�c pl,q ;uc n�« :wd w�Aama��rJ. <br />discrrliou ol Ihc Pubhc w'erks Impcclm. <br />Am� cb,w�e m Ihe dii��rw,rv ud inusl br ��pprovtd by thr I'\t <br />��i�tiur, sprmi widlh. <br />Adjust water Aoxec In r�;�ilc nt end o( conshi�rtinn. <br />IA���cways shall be cumpl�tclV cured befo�c dmin� on thriu <br />,ui} J:uu,i,: Ih-�irto >h:dl b�, rpla�•_�1 :�f 11 <br />Impccini wid�h ai prop Imr Imiiicd t�, <br />Rnollop druua�r �hull fi�� 4i<ch.n,..•d In dn. :In��m dr�iuo�.. .Inb ����,�'��I� d�it iht hum �,I ilr• loi <br />� <br />O <br />� <br />N <br />O <br />a <br />� �� — ACKNOWLEDGEMENT Of COND!TIONS <br />�`, •%� The undersigned ownedapplicant hereby ngrees to hold and save harmless <br />the Clty ol Everett fmm any end all claims lor demeqes, cosis, erpr.nses, or <br />ceuses ol ection thel may erise because of In9lslletion end mnintenence ol <br />Ap ro dforConstruction �e thelmprovementorotherdgh4ol-weyusehereloappliedlorondlurtheragrens <br />�� to remove snme upon notice fmm Ihe City end to replece publlc propeny <br />, ,'/ i� / �/j, � �' �5' S � damagetl thereby. <br />� KX" ��4� <br />FINAL INSPEC110N Dete / <br />Approved as Construcled � _ <br />Signeture of Applicent Dele <br />WOR✓ AUTHORIZEC BY THIS NERMIT MUST BE STARTED WIT41N 1fl0 DAVS OF DATE PERMIT IS ISSUED AND THEREAFfEK�S 1 BE DILIGENTLY PURSUED TO <br />f,OMPLE710N. THIS PERMIT MAY BE CANCELLED BY THE CITV UPON ANY STOPPAGE OF NJORK ON THIS PROJECT OVER FO DAVS DURATION. <br />