Laserfiche WebLink
/21/95 0' <br /> Date_- __ T <br /> Pogi¢Wort.Permit. 4 <br /> Application For Bldg Door o <br /> PUBLIC WORKS PERMIT Nhld Works <br /> r"' d. <br /> op <br /> Less 4.11 rep PUC 9 <br /> Print or Type Oniy axboreDoe <br /> Dennis Petrolium 9826 7th Ave SE Everett 98203 206-353-9701 <br /> Owner kra A�:w..ys GiIY Zip <br /> Phono <br /> Columbia Construction N 16 University Spokane 99206 509-922-8714 <br /> V , �. nddn••, . _ — Gtv ZIP Phone <br /> Applicant — <br /> 6rub <br /> Describe Proposed Work Clear 6 Otsbe site._ (No earthwork. to be done until approved plane)___ <br /> Ere"rOA1 CONTCOG <br /> Project Address UI known) 80th St SW_ <br /> Attach four(4)copies of plans lot proposed work Draw In.acdln.Ind nolo the following as applicable., <br /> • Property Lines • Centarline of street /w <br /> • Outline and dimensions of all existing and • Indicate North v, <br /> proposed structures on IDs lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements <br /> DO NOT WRITE BILLOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1.All calls for inspection shall be made 24 hrs.In advance•phone 259.8810. <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br /> Standards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1.800.424.5555. <br /> 7 /I/o 0&/-aooP- iotno ny /s 4&owc4,/ <br /> S 9ene..rfQ� ZIA;,- oboee'lon A'' /»use 6e <br /> Coq.1ro aeecl <br /> 6. CUCAr,E' 60 Ye dac{rr P/�h 4��ro✓�r✓ o- <br /> (f vp� q ff4 clec� O <br /> a <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 /> Kn_ Q 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 /> 77 ++7 /O l.— _ anphod for and further agrees to remove same upon notice from the <br /> Approved Con truction I C-tv and to replace public Property damaged thereby. <br /> FI AL INSPECTI c ; Date P�o/z5-- <br /> Approved as Constructed Signa re of Ap cae ////JJ of .1 Data <br /> OLPUBLIC WORKS DEPARTMENT WORK RIZED B�S(AERMIT 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:259.8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />