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Dete�f�S� <br />Appllcatlon Fot <br />PUBLIC WORKS PERMI'f <br />Print or Type Only <br />VUEuc Wad� Permil • �l' �y� <br />Brdp Oepl � � /��.JL. <br />Pu���c Worh� Fsa s <br />Tnl�l F�e <br />�eu �pP� Fas PUE i�n n <br />B�lance Oua { ��_ <br />Boyden Realty, Inc. 1429 Broadwav Everett 98 0 ?5 _7t66 <br />Owner Malling Atld�ass City Zip Phone <br />J 6 D Huildere 1429 Broadway Evere[t 98201 252-1166 <br />Applitant Mailing Address City 2ip Phone <br />DeetrlbeP�opoBadWork SinQle Family Ranidnnro � Nav _ <br />ProJecl Addresspl known) 179 — oGrh Srroot S E, EuaroCC ._ <br />Attech four (4) coples ol plans lor proF �ged work • Draw to acale end note Iha lollowinp as applicaL� :: <br />• Property Llnea <br />• OuNine end dimanalona ol all exieting nnd <br />propoaed structurea on Ihe lot <br />• Exislinq end pruposed ulillliea <br />Approved <br />PERMIT CONDITIONS <br />• Centerline ol r,Ireel <br />• Indicate Nortn <br />� Show eny propocad y�adl�ip chauges <br />• Show measwements <br />1. All calls lor inepactlon ehall be mede 24 hrs. in advance � phone 259•881 5. <br />2. All work ahell be pertormed In eCcordenCe wlth thig parmlt antl current City ol Everett Design n.id Cona�ructlon <br />Standerda and Specificatlons. <br />3. Call Locetlon Underground Sarvica 41: hrs. be!ore you dig. TOLL FREE NUMBEq 1•800•424-5555. <br />--� = i - <br />' _.' i <br />FINA� INSFECTIUN � � <br />Approved �s Constiuctr.d <br />everetl PUBLIC WORKS DEPARTMENT <br />� 3200 Ceder Slreet <br />Everett. WA 98201 <br />Phone:259�8815 <br />ACKNOWL[DGEMENT OF CONDITIONS <br />W <br />H <br />� <br />The untler5igned owner/applicenl hereby Bgrees lo holtl end 58v0 herm• <br />less Ihe City oi Everelt irom any and all claims lor demagea, cosls, <br />eapenses, or causes ol aclion Iha� may arise because ol Inslalletlon <br />-�' �T c7�s and mamtenenCe ul �he improvemen� or other rlgh��ol-wBv Uba hereiG <br />applied lor and Imther egrees to remove same upon noDce Irom Ihe <br />Date City and to replace public property damageA thereby. <br />\? <br />•�fi�ratt �i1i �i/.�✓..�,�.� .�`�t'/�� <br />Signalure ol Apphcan De�e <br />WORK AUTHnRIZED BV THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUEO AND THEREAFTER IS TO <br />BE DILIGENTLV PURSUED TO COMPLETION. THIS PERMIT MAV BE <br />CANCELLED BV THE CITY UPON A�V STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />