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<lT� U <br /> Date / / a PUPxc Work,Parmav <br /> Application For 9160 Dept . ,fes <br /> PUBLIC WORKS PERMIT PubimWfee FeeTotal <br /> L.O APOL Fee Paid <br /> Print at Type Only atlx.c.Due f ZDV <br /> JiM Construction 1231 South Director Street Everett, WA 98108 763-0320 <br /> Owner Meiling Address City Zip Phone <br /> Scam <br /> Applicant Meiling Address / \ City Zip Phone <br /> Describe Proposed Work Construct four plex <br /> ,q a LV <br /> Project Address lit known) -6999-BroadudaY Avenue, Everett <br /> Attach four(4)copies of plans for proposed work• Draw to scale and note the following as applicable: r_ <br /> • Property Lines • Centerline of street /dA <br /> • Outline and dimensions of all exiating and • Indicate North V/l <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements <br /> DO NOT WRITE 6ELOW THIS LINE <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection shall be made 24 hOrs. In advance-phone 259.881 S. 0 <br /> 2. All work shall be performed In accordance with this permit and current City of Everett Design and Construction al <br /> Standards and Specifications. <br /> 3. Call Location Underground Service 48 his. before you dig.TOLL FREE NUMBER 1.800.424.5555. z <br /> 0 <br /> 0 <br /> am <br /> eeeeeeeei <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 damal costs, <br /> expenses, or causes of action that may arise because of installation <br /> and maintenance of the improvement or other right-of-way use hereto <br /> Y applied for and further agrees to remove same upon notice from the <br /> Approved for str tion Date City and to replace public property damaged thereby. <br /> �l'yl�sat �(cZ1A l/ �tI Ytp!m <br /> FINAL INSPECTION Date <br /> Approved as Constructed Sign Lure of Applicant Date <br /> everett PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200 Cedar Street 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett.WA 98201 BE DILIGENTLY PURSUED TO COMPLETION, THIS PERMIT MAY BE <br /> Phone: 259.8815 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />