2632 58TH ST SW 2016-01-01 MF Import

. .r... E 2 'ZE5 Date 3- 1` r t •'' 'l I Pubhe Work.Permit a Application For —.� nngl% 1- / �1( Bldg Dept . 47644 PUBLIC WORKS PERMIT public Total a Leu APPr Fee Panda_ Print or Type Only ny 8 g Balance Due e ' o, rip[p cid o p •R .•. M M MM '-r - LD6D Conatruction 21007 474 irr SE Bothe 91021 4%5-4344 Owner Me g'A rase zz �CjI p( Zip Phone Owner S 2TS m rA —r r, a Applicant Mailing Address City Zip IIJ Phone Describe Proposed Work new !iouae ^•w.. I for 21 Powder N111 fiinhlnucl Div 7 Project Address(if known) 560 & 51V UJ Attach four(4)copies of plans for proposed work- Draw to scale and note the following as applicable: sti • Property Lines • Centerline of street • Outline and dimensions of all existing and O Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements DO NOT WRITE BELOW THIS LINE O PERMIT CONDITIONS 1.All calls for Inspection shall be maCa 24 hrs.In advance-phone 259.8810. 2.All work shall be performed in accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3.Call Location Underground Service 48 ire.before you dig.TOLL FREE NUMBER 1.800.424.5555. 4 Instal rook conalructlon entrance behind drweway as per city standard 0208 and erosion control as directed by Publr Ylorks Inspector. 5. Keep city streets clean at al limas S. Curb gutter and sidewalk in The plat are new and undr.inaged. any damage thereto shall be replaced at fie discretion of the Public Works Inspector. ♦A 1.Any change In the drlow ay cut must be approved by the PW Ili-' O spector,width at prop Ina Imhod to erl„Ing apron width. 8 Connect al roof,yard and driveway drains to storm drain system provided to lot. a g.Adjust Paler boxes to grade at and of construellon. 10 Drivevays shsl be completely cured before driving on them. ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett from any and all claims for damages• costs, expenses, or causes of action that may arise because of Installation L r r (, •/1, I Ire 3 _ G't_[�!1 and maintenance of the improvement or other right-of-way use hereto 7 Approved for Construction Dale applied for and further agrees to remove same upon notice from the City and to replace public property damaged thereby. ✓ � y /E' dl� FINAL INSPECTION Date I+ Approved as Constructed Signaluie ol p-plican Date PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 3200 Cedar Street 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO Everett.WA9B201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE Phone:259.8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.