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uate�=24=92 <br />� � � <br />Application Fo� <br />PI.yBLIC WORKS PERMIT <br />Print or Type Only <br />The Tredway Co <br />Uwner <br />TO POSTING g-z1-q5 <br />� PO Box 3014 f <br />Mailing <br />Owner <br />ApPhcant Mailing Address <br />Describe Proposed Work neW }1oUee <br />Prolecl Address (il knownl <br />tt 98203 347-7:84 <br />Cily Z{p <br />� � ��"'J__ <br />n�m•�� w�,we r.�m�i . � <br />e�na o�4• . _ 37494 <br />Pu�l¢ Wnrxs Fee <br />Tote� Fen S _ <br />Leaa �po� Fee Vne S <br />Beiance0ue .i �� <br />Attech low (4) coDies ol plans lor proposed work � Draw lo scale 2nd nole the followiny os apphceble: <br />• Properly lines • Centerline ol slrael <br />• Outhne and d�men&ions ol ell exi5ling and • Indicele No�th <br />proposed structures on Ihe lol • Show nny proposed grading chenges <br />• Ezisting and proposed utililies • Show measurements <br />Phone <br />PERMIT CONDITIONS <br />1. All calls br Inspection shall be made 24 hrs. in advance - phone 25U•8810. <br />2. All woik shall be performed In eccordance with this permlt end current City ol Everett Design end Consir��ctlon <br />Standards end Speclflcationa. <br />3. Call Locetlon Undergrountl Servica 4B hrs. belo�e you dig. TOLL FREE NUMBER 1•800•424-5555. <br />�. ��SI �G.? fiC� / �.�^��1 ���'-✓ �'`�S"fG.s� /�c�.J11�-�L <br />.� ! .. <br />C',;.�3-fir.c-f �.-� ,,� �� c i�, i� <br />ApProvC�o 1 onslruction � Dale <br />i / / <br />� �!4�/� <br />i � <br />FI AL I� CTION �������� Date <br />Approved as Conshucted ° <br />�PUBLICVlORKSDEPARTMENT <br />3200 Cedar SVeet <br />Evera�t. WA 98201 <br />Phanr.�.259�9810 <br />�'� �'�`_ "".-' %�'.'—� <br />W <br />� <br />� <br />� <br />� <br />O <br />'�A <br />V� <br />O <br />a <br />ACKVC".NLEDGEM[NT OF CONDITIONS <br />The undr.isigned ownevapplicanl hereUy agrees to hold and save harm- <br />less Ihe City o� Everetl Irom any and all claims for dampges. cosls, <br />evpenses. o� causes ol ection thal may anse bec,.use ol instellation <br />and mamtenance ol Ihe improvemenl or olher �Ighl�obway use hereto <br />nppiieA lor end furUier ngrees to remove seme upon nn�ice irom ih� <br />Gty and10 replace pubhc o�oPerty damaged Ihereby. <br />o nniwe nppucam U21e <br />OFK AU HORIZED BV TIiIS PERMI MUST BE SiART[D WITHIN <br />1P0 DAVS OF DATE PERM17 IS ISSUED 4ND THEREAF7EF IS TO <br />BE DILIGENTLV PURSUED TO COMPLETION. THIS PERMIT MAV BE <br />CANCELLED BV THE CITV UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAVS DURATION <br />� <br />CITY OF EYERETT <br />PUBIIC WORKS DEPARTMENT <br />BUILDING DIVIS[ON <br />NOTICE OF CONUITIONAL ACCEPTANCE FOR <br />FILING OF BUIL�ING PERMIT,APPLICATION <br />Appl;cant: <br />Address: <br />Project Name: `�'��1�.l.c! �?�,.,,r„oQn yz-CP , <br />Project Address: _�� �p �� S { S [-- <br />- �a��,,, T <br />At this time, your building permit application is being conditionally <br />accepted rar filing, pendin9 the determination of its completeness and <br />whether any additional land use approval(s) including but not limited tu: <br />Zoning Code <br />State Environmental Policy Act <br />Shoreline Management Act <br />is required in order to camplete yaur application. <br />If the City review determines that any additional la�d use approval or any <br />additional information is required to complete your buitding permit <br />application, it will be necessary to submit this additional information or <br />acquire the additional land use approval prior to ��our application being <br />considered complete ,for filing. If no other land use+approval or additianal <br />infcrmation is required, your building permit application will be considered <br />fil^_d as of this date. <br />Fe+s charged or refunded wi11 be in accordance with Section 3U4(c)(f) of the <br />Um form Building Code. <br />Valid only when signed by both parties: <br />� y;,, --,_ -,� _ q -, <br />� , �_ <br />ica o u ortze ent Date <br />�,�,1 fi.� <br />�ity o� veret n Tce Tecnm cian <br />( 4456 ) <br />ae <br />.� <br />