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9/11/91 / <br /> Date TO POSTING.3 d,0.01 <br /> — oleo o.Pt • 9 1/2 7680 <br /> Application For <br /> y"H WORKS PERMIT <br /> .�, Pustx Word1 Fad <br /> PUBLIC, !4 <br /> l' yToldi Fill <br /> p x leo xPPL Fdd Pod d <br /> G' H adie�ceDud t{ ZO <br /> ta, �7f/t Print or Type Oriy <br /> it �* <br /> Hllanabrook Inc E4020 Main Spokane 99202__74-0044 <br /> Cn H Owner Malting Address ,R� Its r _ , tip ; PhO. <br /> tC-.�Y r} =• 1-- �/ M1 L ,il�fyJ� 4n yi. IU <br /> 7i7i fC G� LJ LJ <br /> (O H C7 Applicant Melling Address City Zip Phone <br /> Hag ` <br /> Construct new 1196SF tri-level <br /> C Describe Proposed Work <br /> x H -- <br /> 9H[3Yq <br /> t" <br /> En H <br /> Tit <br /> @ th Project Address(if known) __202 60th pl SEq CA <br /> H O TA Attach lour jai copleb of plans,or proposed work- Draw to scale and note the following as apphcahin ria <br /> • Property Lines • Genterline of street <br /> • Outline and dimensions of all existing and as Indicate North �♦ <br /> proposed structures on the tot • Show any proposed yracling Oianyns <br /> • Existing and proposed utilities • Shaw measurements Im <br /> DO NOT WRITE BELOW THIS LINE O <br /> �. PERMIT CONDITIONS <br /> 1.All calls for Inspetti to shall be made 24 hrsin advance-phone 259-8810 <br /> 2.All work shall be performed in accordance with this permit and currant City of Everett Design and Construction s/ <br /> Standards and Specillcations. <br /> w' 3.Call Location UndenTround Sdrvice 48 hrs.before you dig TOLL FREE NUMBER 1-800.424.5555. <br /> 4. Install rock construction entrance behind driveway as per city <br /> standard #208 and erosion control as directed by Public Works <br /> Inspector . <br /> w 5. Keep city streets clean at all times <br /> 6. Curb gutter anG sidewalk in the plat are now and undamaged, <br /> any damage thereto shall be replaced at the discretion of the <br /> 11I1Puhl is Worits Inspector. <br /> pproved by the Public <br /> 7. Any change in the driveway cut must he aO <br /> Works Inspa Anr. <br /> A. Tightline n: l roof, yard and driveway drains to storm drain <br /> stubs at back side of sidewalk. <br /> 9. Adjust water boxes to grade at and of construction. <br /> 10. Driveways shell he completely cured before driving on them. <br /> .� ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm• <br /> less the City of Everett from any and all claims for damages, costs. <br /> expenses, or causes of action that may arise bec.iuse of Installation <br /> C) <br /> 1/4—)I and maintenance of the improvement or other rightol-way use hereto <br /> applied for and further agrees to remove same upon notice from the <br /> Approved lot Construction Date City and to replace public property damaged thereby. <br /> FINAL INSPECTION Date �! ' <br /> Approved as Constructed Signature of Applicant Date <br /> WORK ABY THIS PERMIT MUST BE STARTED WITHIN <br /> PUBLIC WORKS DEPARTMENT <br /> 180 DAYSS OF OF DATE DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 Cedar Street BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Everett WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259.8810 PROJECT OVER 90 DAYS DURATION. <br />