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Dete 7-13-99 <br />� �hratbn For - . <br />PUBLIC WORKS PERMIT public Worka Permit N zz8 <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everelt, WA 98201 (425) 25j�L1 i� z�03 Building Pertnit 11 B9907-025 <br />� p0 <br />TYPE OR PRINT ONLY =A s U STI N G �' Pubiic works Fee S RD � <br />Dill Guetaveon PO Sox 2707 Lynnvood 98036 206-972-1479 <br />Owner Malling Address City ZID Phone <br />ApPlicant Mailinp Add�eas Ciry Zip Plwne ^ <br />Describe Proposed Work 4 ' <br />PROJECT ADDRESS (il known) <br />�a <br />Atlach lou� (4) coplos plans lor p�oposed work - Draw lo ecele and nolo Iho Idlowing 11 applkabla: <br />• Proparty Unae • Outline and dlmenWone ol all e►Istlnp end proposad slnx.Muroe on Ihe bt • E�ISUnp arxl Droposed utflitlee <br />• Cantodlna ol struet • Indlcate NoM • Show any proposod gredinp chanpes • Show moasuremants <br />DO NOT WRITE BELOW THIS LINE <br />PERMIT CONDITIONS: <br />1. All calls far inspectlon shell be mede 24 hours in advance - phone (425) 257-8810 <br />2. All work shall be peAormed in accordance with this permit end current City of Everett Design end <br />Conslruclion Stendards end Specilications. <br />3. Call Locatlon Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1-800-�24-5555. <br />¢ Si Z�' �vo,e,�' �O,e The.t� �- Plexes ar;yina L dor,e �r <br />C�viC �Lai� 4�P�ov�'d � P�6C�c �✓o�,fS on /a3/-9S <br />$: I�sftt-�L Cap on sides¢�.,ie� {�'r !of 2. �%�s� <br />���;�y �,Q� P,� ;s ��. <br />(o. i�i�jo CCrj� ,ffr�.�7` Clean Q� aLi tFii�e.S <br />,y�.5y <br />� .,k� <br />C <br />FINAL INSPECTION <br />ApprovoU ea Constructod <br />� <br />� �' <br />Dale <br />W <br />� <br />� <br />� <br />ACKNOWLEDOEMENT OF CONDITIONS <br />The urWenigned o�merlepplicent Mreby epiaes to hold and save hertNess <br />V�e Gry ol Evered Irom arry clekns for damapes, ms1s, e�pmxs. a <br />causee ol e Met because ol ImlaMtion erM mekiMronce d IM <br />Impiwement olhe uae Mreb appliad Iw and IuMer epreei b <br />remova Gty end a replsoe pudic propeM Oem. <br />aped Me <br />ia a-g� <br />WOFiK AUTHOR�D BY THIS PERf.ttT MUST BE STARIED WITHIN 1B0 MVS OF DATE PEW.fT �S ISSUED MA lFEiEAFiER IS 10 � DLXiENTIY R1FiSUED 70 <br />OOMPLEf10N. THIS PEFiM1T AMY 6E CAN(�LIED BY T1E l..'T' UPOIJ ANY STOPPAOE OF 1M�Fi( ON 1HS PRO�ECT OVER 90 DAYS OUM710N. <br />