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�, /, ' ' ; <br /> �et@_],p{12.{�p Puei¢Wna�Pa.mn� _� � <br /> .` AppGcation For <br /> eiea oso� • 89/2308 <br /> ' PUBLIC WORKS PERMIT d��.s~ — <br /> PUCI¢Worh�Fee <br /> Tol�l fee �_� <br /> Len�ppl fee P�iE �� <br /> Print or Type Only e���nce oue i ��� '�� <br /> �asino Road Aeeociate 50 – 116th Ave SE N210 Bellewe, WA 98004 454-8900 <br /> Owner Maifing Address City Zip Phone <br /> .Same <br /> Applicant Malling Atldress City 2ip phone <br /> Desai6e Prnposed Work Apartment Complex – "Victotian Place" <br /> Prolec�Address(il known) W. CA8�14 Rd & llt}I Dt. W. — �d�� �• �lt.f/ 19 d O�- � <br /> � <br /> Attach lour 141 copias of plans for proposed wrnk- Draw Io scale and nole ihe following as aPGhcable: � <br /> • Property Lines i • Cenlerhne ol streel �. <br /> • Ou�line and dimensions ol all e�isti A • Indlr.nle Norih � i <br /> proposed structures on Ihe�ot • Show any praposed gratling chenges '• <br /> � Ezisting end proposed utilil' • Show measuremenfs � ' <br /> 0 NO ITE BELOW THIS LINE , <br /> PERMIT CONDITIONS O <br /> 1.All calls lor inepeclion shall be mede 24 rs.in ed nce hone 259•8810. � <br /> 2.All work ahell be perto�med in accordenc ith s permit d cunenl Clty of Everett Design end Constructlon <br /> Standards end Specilicatlons. <br /> 3.Call Locetion Underpround Servic B hru.before dig.TO FREE NUMBER�•BOO.OZO•SSBS. � <br /> �: ��✓ alv�r �s �o� 9 -z � - 9v O <br /> �� n <br /> V ~ <br /> � � <br /> � O <br /> C� a <br /> ACKNOWLEDGLMENT OF CONDITIONS <br /> Thr.undersigneA owner/epplicant herehy aa�ees lo hold and save harm� <br /> — less Ihe City ul Everetl Irom any end a, claims br damngas, cosls. <br /> � -e�penses, or causes ol ndion thal AIAy 9f15A because ol instellation <br /> � �`� i,- end mainlenance ol lhe improvement m other right�ol�•May use herelo <br /> pplied lor and lurther agrees lo �emove seme upon nolice Irom Ihe <br /> Appr lor'Con uctio e C1ty and�o replace publlc property damapetl ihereby. <br /> FINAL INSPECTION Dete <br /> Approved as Conslructed Signalure ol Applicenl Dale <br /> everett PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> � 3200CedarSireet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Eve�ett,WA9820� BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BE <br /> Phone:259�8810 CANGELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THI <br /> PROJECT OVER 90 DAVS DURAiION. <br />