Laserfiche WebLink
Applicetlon For <br />PUBLIC WORKS PE�3MIT <br />Print or Type Only <br />J 6 D Buildera 1429 <br />Malling Add�ess <br />Deacrlbe Proposed Work �$1IIQ10�timl�.Y Raa� dence <br />Pro�ect Address (II known) <br />Everett <br />a�y <br />� <br />Pepi�c Wo�w� Perm�t • --9� � � __ <br />BIEp Dep1. • �� �• � �— <br />VuELc Wod� Fee <br />Toblfee s <br />lcu �DC� fee Pe�O s <br />e�i��ceow 3 �G/�Q <br />'%G qs <br />98201 252-1166 <br />Zip Phone <br />98201 252-1166 <br />Zip Phone <br />AU�ch low �4) copiea ol p!ans for proposed work � D�aw �o scale nnd nole tho following es epplicable�. <br />• Property Lines • Centerline ol s�reel <br />• Outline end dimenelons of all eKisting and • Ind�cale North <br />propuaed atructurea on Ihe lot • Shovi nny proposed grading changes <br />• Exlating and proposed ulilltles • Show measurements <br />PERMIT CONUITIONS <br />1. All calls lor Inapoction shall be mede 24 hra in advance - pt�one 259•881 5. <br />2. All work ehell be performed In accordance wifh ihis peimR en0 current Ci�y ol Everett Desiyn and Cons�ructlon <br />SI andards end Specifications <br />3. Ci�ll Locetlon Underground Service 40 his. belore you dig. �OLL FREE NUMBER 1-BOO•424•5555. <br />Approved for GonslrucUon / <br />FINAL INSPECTION � <br />APproved as Consiructed <br />everetl PUBLIC WORKS OEPARTMENT <br />� 3200 Ceder Street <br />Everett, WA 98201 <br />Phane:259-8915 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />The urders�qned ownor/applicunl hereby aq�ees �o hold and save harm- <br />Iess Ihe City ol Everett hom any and all claims for damages, costs, , <br />exprnses. m causes ol aclion Ihat may erise because ol installatlon ; <br />and mainlenence ot the improvement or other rianl-obwey use hereto � <br />npplied lor and Iwther agrees to remove seme �pon notice Irom tha <br />City �nd tc replace pub -. prope�ty demaged thereby. <br />�-� /�� �.�.e..— �i_ �T�' �e � ss - <br />Date <br />'�igneWre of AppliCenl 1e <br />WORK AUTHORIZED BV iHl.". PERMIT MUST BE STAATED WITHIN <br />180 DAVS OF DATE PERMIT IS ISSUED AND THEREAFI�ER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BE <br />CANCELL::D BV THE CITV UPON ANV STOPPA�E OF WORK ON THIS <br />PFOJEC'�� JVER 90 �AYS DURATION. <br />