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Date�;%.�S � <br />' ,,>„���;,����� ��� <br />PUBLfC WOF�KS P�EF�I�111T <br />Print or Type Only <br />Mai6ny <br />�,r''',�, <br />—�'n — <br />Applicanl Malling Addwss City <br />,,.� . �•., ... �,.,,., � . _.� I - 7 1 <br />,,, ,, �,..,,� . �/�_Z � �..i `-� <br />P��`na WOrMf fPn S — ' � <br />IfO1Pl�pn <br />lnef �np� F�e PaiJ S— <br />7 <br />Barn�rn Dur S c-��) � _ <br />_3_3��-SY�� <br />Zip Phone <br />Desr,ribePropos�dWork_���'(��_�_ ���_L�ILiGs.(�_LQN._.�_ <br />/ <br />Pro�ect Atldre55 �d known) � ��J �%Si.h S� S�� <br />A�laGh lour pl� copi�•s ol Plans lor proposed work � Draw �o scile and note ihe lolluwmg as apphcahle <br />w Proper;y Lines <br />• O�'hne and dimensi0ns ol all eRishng anA <br />propusetl structures on hr lot <br />• Exisling and proposeA idmties <br />• Centerlme ol slreet <br />• Indlr.ate Norlh f <br />• Show any nropoSeA q�a��LW.i%ryes1�46FM �OOL1N598�? <br />• Show measuremenis / <br />DO NC�T WNITE BFLOW THIS LIN[ BLDG Z4�B.00 <br />PFPMITCUNDITIONS fLEG 845.00 <br />1. All calls lor Inspection shall be made 24 hrs. in advance � phone 259•8810. FLEG 590.00 <br />2. AII work sliall be peiformed in arcordance with ihis perml� and cunent City ol Evere�l Uesi�i �.ZionsiruA(dfi0 <br />Slandaids and Specilications, 'J / $��.00 <br />3. Call Locallon Underground Service 48 hrs. belore you dig TOLL FFEF NUMBER 1•B00•���i. <br />4. Install ro�k construction entranre b=�hinct drivg�p asfz�g7 cit/ <br />standard k20B to reduce tracking mud onto streg�-gncl��,pR;��ion <br />control as di.rected by Fublic Works Inspector.qD0007161 <br />5. Keep city str��ets clean st all times. WpTER 5130.00 <br />b. Curb, gutter rnd sidewalk in the plat are new �y,un�ggd. <br />any damage thereto shall be replaced at the discretion of the <br />Fublic Warks Inspector. <br />7. Any cliange in tle driveway cut must be approved by the <br />Ficblic Works Inspe�tor. <br />8. Tiqhtline all roof, yard and driveway drains fror�i houses to sto <br />drain stubs at back of side walk with rubber qasket F.V.C. pipe <br />9. <br />ln. <br />Adiust water boxes to grade at end of construction. <br />Driveways shall be completely cured before drivinq on them. <br />1-C .w� Yl . i=e�. Z' "LS'`�I <br />Approved lor ConStr cf n, ^ Date <br />— ��� (�'.l� : /--- �-�f '/ <br />FINAL INSPECTION Ualc <br />Approved .as Consirucled <br />evi�rrit PUBLIC WORKS DEPARTMENT <br />� 3200 CeAar Slreet <br />[crtrelt WA 9d701 <br />Phnnn� :5'J R510 <br />ACKNOWLEDG[fdENT Of COND1110N5 <br />� <br />� <br />� <br />Y/ <br />O <br />a <br />The undersi9ned ownrVapplicant hei i!ty a�rers lo hUd and save hann� <br />less ihr Cily ol Evcrelt hom any and nll ciaims lor dani[fn.�s, msL. <br />eepensEs. or causes o� action that �r.;i arise hecause o� n�sta�lation <br />and maintennnce ol Ine imp�ovemen• o� oiher nphl-ol�way use hcmio <br />npPh� tor ,�nd lur�h��i arlrees to remnve samq uU�n nnticc from ihi� <br />Ciry. d�R 'r.t! puJhC VrUpei Aarna9ud Ihoreby <br />�h�nr���—_--'— <br />S�rc n APn �+ ��—' Datc <br />WbRK �UTH�NI =D BY THIS PFRMIT MUST BE STAFTCD WI�HIPI <br />1B0 DAVS OF DATE PENA11f IS ISSU[D AND THEREAFTER IS TO <br />BE DILIGENTLV PUR3UF:D TO GOMPLFiION THIS PEf7MIT MAY O[ <br />CANCL LLIID tiY 7HF CII V'JPON ANY ST(�PPA(;I� OF WOGK f1N THIti <br />{'HUJI.Ci O;'�N ��0 DAY"S �111(7Ai11)N <br />