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G� <br />PUBLIC WORKS PERMIT <br />Cdy ol Everett Pubhc Works Department <br />3200 Cedar Sueet <br />FveretL WA 98201 <br />(425) 257-8810 <br />OWNER NAME AND ADDRESS: <br />MOUNTAIN VIEW PROP[RTI[S <br />761 16TH PL <br />MUKILTEO WA 9827;, <br />PHONE: � 52399924 <br />PARCELIDII 2805300040190 <br />DESCRIPTION OF PROPOSED WORK: <br />NEW HOUSE - ADAIR BASIC 324 <br />Date 4I28I2009 <br />Public Works Permit #: PW0904-038 <br />Buildinq Permit #. C0904-013 <br />Planninq Reference #. <br />Public Works F::e 5 $ 25.00 <br />Other 5 <br />APPLICANT NAME AND ADDRESS: <br />PHONE: <br />SITE ADDRESS• 1519 126TH ST SE <br />LOT 2, SHORT PLAT <br />PERMIT CONDITIONS <br />1 All calls for inspection shall be made 24 hours in advance <br />2 All work shal! hF �erfcrmed in +ccordance wdh lhe permd and current Cdy of Everett Design and ConstrucUon Standards <br />and Speci6cations. <br />3 Call Location Underground Service 48 hrs before you dig TOLI FREE NUMBER 811 � <br />4 Roof drainaoe I�';e ui�ct,v�ued to a dispersion trench <br />5 Contractor mist n�ee: v. �h the PuUlic Works Inspector pnor to slart�ng c�nstruclion Cal CIiH at 425-3::3-7404 <br />TQ pC�STING_: _�_._ <br />�-�,1. � � K g. O <br />l�pproved for Const�uclion Dal <br />i i,��_,,,�/i� ` �- '% <br />.r — = �'------ <br />INSP[CTICN' Dale <br />ApprovedasCcnstructed �' /B-Oy <br />F" <br />.r <br />f <br />m <br />O <br />� <br />z <br />0 <br />�- <br />� <br />0 <br />�. <br />ACKNOINLEDGLMENi OF CCNDITi0N5 <br />t he unders�gr�ed oH•nedapplicant hereby aqrees lo hold and <br />save I,�nnless ihe City ol Fverett Irom any and all claims lor <br />dainages. costs. ezpenses or causes of action Ihat may �^�e <br />6ecause ol msfallalion and ma�ntenance ol lhe improvem� � <br />or �Iher nghl-ol-way use herelo apphed lor anA furiher agrees <br />to remove same upon nohce Iwrn Ihe City and to ieplace <br />public property damaged Ihereby <br />� j� <br />��- �l 1��.,��� <br />i <br />SIgwJlure ol Applicant Date <br />IVORK AUiHORIZCD 13V 11115 PCPt41T IdUST II[ ST�RTCD 1VI7MIN IHO DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE D�LIGENTLY <br />PUFSL'! D �O (:OF1Pi I I IOY 1 HIS PCIiI•11 � 11Av 13C UkCI I l CU flY THC C11V UI`0�� ANY STOPPf.GE Of 1NONK ON THIS PROJECT OVER 50 DAYS DUfiAT10N- <br />