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� <br />� <br />TYPE OR PRINT ONLY <br />Appketbn Fa <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 CeAa� S11eM <br />Everett, WA 9B2U1 259-8810 <br />TO POSTING � 3� � <br />��a s/z��9a � <br />A,ni� H�6 �n M _ q��ZlO <br />e�udi�9 aa,,nn � _ 58905 __ <br />Aublk Wo/ka f"ee S 2 �� <br />_ SELBY JOHNSON CONSTRUCTION 1222 SPRINGBROOK RD LK STEVENS 98258 �,25-334-7400 <br />Owner MallingAtlyrese Gty 7�p pryo�- <br />. -,.. . . � �t;��i <br />Applkant MaIIInpAddre� pryy Z�P :�,.A, ` ,..,p�� � <br />-`I'��111� "7_('� <br />Describe Proposed Work NEW DUPLEX - BASIC 11 <br />PROJECT ADDRESS (if known) <br />h <br />Attach lour (4) coples ol plana lor propoaed woAc • Draw to xale and note tM lolbwinp It appllcable: •�• �--���� - <br />'Property lJnee �putline and dimensbns ol ell exleting entl proposetl atrueturea on thn bt 'EMlelinp`end proponed utllitl!$ - <br />�Centerllix of etreel •Indicale North 'Show eny propoeed gradirp chenpee �Show measurereenib � '�``' ��' � '' �� <br />�5�_ll <br />DO NOT WRITE BELOW THIS LINE • _ ., <br />PERMITCONDITIONS: � ;� <br />1. All calls for Inspection shall be made 24 hours In advance - phone 259-88� 0. ' <br />2. All work shall be performed in accordence with lhis permit and current City of Everett Design and '�_ <br />Constructlon Standards end Specifications. , <br />3. Cnll Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBEp 1-800-424-6666. <br />ln°inli ;m �nf��llt�,dinn hr•nch huill ns �rr Seclion ± 2 G? nnd I'i�um and'Cahle �-2.? nf fh� cilv <br />';�onn«��trr M:ms�¢emrnl Msumnl (copy�s At�y�led to this pern�it 1. 'llu� iutill�ption trench xhall <br />na clover ticm S[��et tu ;my up slope ��ropetiy liue or f�unJef ion nor cloeer ihnn 10 feet to viv <br />do�Hi�iope pro��rii}� line or �oundnlinn. �'�II Public R'orkti 1'or an iuvpection prior to cov?rin� <br />��,,�<�i�,�� <br />I:srim�:lr. 'Ihiv �tntchire heo s�prox Z S�p��q Ff. of impren ion� roof nr�a, 'fheretor�� - <br />d�n pnil cl.�n� of hrrrmr sa�i�l ix acyNumrd w�d the intillration trench ie conatucled <br />�rlr•rn nn�+ tR, wide, tiom lable 3-2 2 Ih�� trcnch ehould bc Z 3 1. Lun . <br />Jr ie Ih�� d�v��lo���•r•� re�•pon�ibilil�� lo id�•ntitt� Ni • sr,il cla�a m the ti�•Id �md if'conditiona in di�� fi��ld <br />� ni�' from tho�:e m Ihe rxswi�rl�r - �ul�uvl F�ccorJincly uein4 11��• �l�ove mentioned teble nx ti quid:�. <br />S. I" DoMcs�r� Nyo - z+�-F�rre�fi� rw F►.esr. Per o.p,�.w„ ?�telae <br />����e. 7�Z�7�9'a <br />Ap roved lor Conswctbn Dele T— <br />.b. ���.. .2 ' /.2 - Q�j' <br />FINAL INSPE ION pg�B <br />W <br />N <br />� <br />� <br />� <br />� <br />O <br />a <br />g„�r.�+w,.j� <br />ACKNOWLEDOEMENT JF CONDIT10N3 <br />Tha undenlpned owne:/epplkant hereby epieee to hold end seve harmbse <br />tha Clty ol Everetl h om eny and ell r,lalma la damapee, coele, expeneee, or <br />ceusee of ectbn Ihet may erlas heCau[e ol Inetellatbn and malntnnence of <br />Ihe vrprwemenl or 01her rlpM-cl-Y/ey we fro�010 epplled for antl IuAher ep�eee <br />to romow mme upon notbe hom the Ctly end ro replxe pudk propeAy <br />damaped theruby. <br />I ApProvad as Co�structed I n��-- �G /Y 2 u /�� <br />/ <br />!w V <br />Slpnature oiApplI/� nt �T— ps�e <br />WORH AUTHORIZED BY THIS PERMIT MUST BE STARTED WI RiIN 1B0 DAYS OF DnfE PERMR IS ISSUED AND THEHEAFTER IS ?O BE DILI6ENiLY PURSUED TO <br />COMoLETION. THIS PERMIT MAV BE CANCELLED BY THE CITV UPON ANY STOPM�E OF WORK ON THIS PNOJECT OVER BO DAYS DUMTION. <br />