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� <br />1YPE OR PRINT ONLY <br />nvw�wrm Fa <br />Pl1BLIC WORKS PERMIT <br />PUBLIC WORKSDEPARTMENT <br />3200 Cedar Street <br />Everett, WA98201 259-BB10orT r <br />TO POSTING `� ° <br />/ <br />Date____ o-o-vo __ <br />Public Worke Permit N =(,(1���_ <br />Bullding PertnN M 59762 <br />P�on� won�a F� s �i� � <br />Don Locken 2116 131et Ave NE Lk Stevene 98258 334-1915 <br />Owner Malling Address City 21p Phone <br />Owner _ _ <br />Applicant Melling Atldress Clty Zlp Phone ^� <br />Describe Proposed Work <br />new houna <br />Nae�ic 2009 <br />�:i-._v- �a �:'•i`�`1 <br />f� ,- �'6� <br />_.. .��..P..J <br />� }i�l . l/O <br />— �.,.�� <br />PROJECTADDRESSQfknown) 2402 116th St SE Lot 1 SA�Abi-97 ••-� <br />.,� _i,.�� <br />Attech four (4) copes ol plans for proqised work • Drew to scale end nute t�e followinp II eppllcaWe: .�� �l� �� <br />'Proparty lJnes 'Outllne end dimensione of ell ezistlng and proposed slructures on the bt •Existing erb proposed utilhb} •��) <br />�Centerline ol etreet "Indicata Norih 'Show eny proposed grading chanpes •Show meesuremlM9 �,; - 1 :�;� �,;:v <br />vvrvui rrn�iao�wr� �no��n.� � ,�::} ; <br />PERMIT CONDITIONS: <br />1. All ;,alls for Inspectlon shall be made 24 hours In advance - phone 259-8810. � <br />2. All work shall be peAormed In eccordance with this permlt and currc�t City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Locatlon Underground Service 4B hrs. before you dig. TOLL FREE NUMBER 1-800-424-6565. <br />In �t:dl an intillr;dion tr:nrh hnilt ;i� p�•rtirction 3-2.b.? �mi1l'igurc �md'1'nble i-?..? ofth� cily <br />donmatilrr M�meaetncnl A1.musJ f���p)' �� Gt}q�led lo Ihie penuii). 'llic intillrFllion lruch shall <br />��o closcr Ih.m 5 fcel lo �ury up �lap�• properl�� line or foundation nor closer thnn lo Teel lo twy <br />ric�anel.>pe pmpeH�� line nr t�ovad.+lion �'rdl Pnblic Worke for �u� inspectiou pnor to coverin¢ <br />ir..uch� 4 <br />I�: un;,lo '(hi4 atnicture h:�e aprrox. 1'Tw `�q l�Y. ol'imprciti•inuG roof sven 'Ihemfnm <br />II fl POII iIDNB 0� IO(ll@/ Shcl(I IN SINR9Ut11P(I llll(I �IIP If111II1'{IIIOfI ifP11CI1 IF C0119111C1P1I <br />d. detn rn�d?li. n�irle. from tt�ble i-Z.2 thc Ircnch �:hould bc ��j . Gnr� . <br />�� i� Ih� drr��lopers re�ponFibility fo idcntitv thc �oil class in thr field and if conditione in the field <br />�:u� from Ihoec in Ihe ezsm�ple - ocljust eccordinRlV ���inR Ih�� abnvc menlioned (td�le u� � Ruidr <br />�_/ �rflr�r:� tu Ih�� �ii}�'s smoll parcel I�cat mnn�gcmcnt prn,^ticcG n� ?tntcd in �..clion '_-? 2 ol'!hc cit}� <br /><«` I��•�ien sma �'onstrnclwn Slnndsudv �md Sn�citicetione for I)evclnpme�d (nit.�cbed�. <br />���' <br />(s,«,�. M'1 ���. 8✓/�'✓✓qB <br />Appmved lor Construcllon Dete —� <br />a. �� �,t.:., _ �-.�6 -ss <br />FIN4L INSPECTION Date <br />Approved as Constructed <br />ACKNOWLEOCEMENT OF CON�ITIONS <br />The un7enlgned ownar/epFlkant hereby egrees ta hold end seve harmless <br />Ihe Clry of Everatt Irom any and ell clalms I�i damages, costs, expanses or <br />cauces o} eclion that mey erlse because ol Inetallelbn and malntenance of <br />the Improvement or other riphlal-Wey Use herato applled lor end fuAhar apieee <br />to ra�nove same upon notfce Irom Ihe CIty end to 2pleca publk pmperiy <br />demaged thereby. <br />n� ��� �9g8 <br />ature o/ Applkent DatB <br />WORK AI,THORIZED BY THIS PERMIi MUST BE STARTED WITHIN 1 BO DAVS OF DATE PERMI7IS ISSUED AND THEREAFfER IS TO BE DILIOENTLV PURSUEL TO <br />COMPLETION THIS PERMIT MAV BE CANCELLED BY THE CI?V UPON ANV S70PPAGE OF WORK ON THIS PROJECT OVER BO DAYS UURATION. <br />