3827 WETMORE AVE 2018-06-08 - Laserfiche WebLink

Date_` a " Public works Permit x —____________4 Application For Bldg_Dept.a PUBLIC WORKS PERMIT Public works pee Total Fee S Less APPL Fee Paid $ Print or Type Only Balance Due $ Owner ..V „ . . I i - Mailing Address City _JP. Zip Phone - pCIl icatr Mailing Address City Zip Phone Describe Proposed Work I -/ Project Address(if known) Attach four(4)copies of plans for proposed work-Draw to scale and note the following as applicable: sr • Property Lines •Outline and dimensions of ail existing and •Centerline of street • Indicate North proposed structures on the lot •Existing and proposed utilities • Show any proposed grading changes •Show measurements DO NOT WRITE BELOW THIS LINE PERMIT CONDITIONS 1.All calls for inspection shall be made 24 hrs.in advance-phone 259-8810. 2.All work shall be performed in accordance with this permit and current City of Everett Design and Construction • Standards and Specifications- 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800-424-5555. �/ ` r (. CL \C/c -1-- v �_ ere},. tf-/.1 ('tr�ti`- _Cd Lrw-•,- '4":4,1G lc �/� ( � • ', - ACKNOWLEDGEMENT OF CONDITIONS Ct A The undersigned owner/applicant hereby agrees to hold and save har less the City of Everett from any and all claims for damages co I expense& or pauses of action that may arise because of installati and maintenance of the im)rovement or other right of-way use her Approved for Construction Date i applied for and further agrees to remove same upon notice from t City and to replace public property damaged thereby. FINAL INSPECTION Date Approved as Constructed Signature of Applicant everettREAFTER IS PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY T Date 3200 Cedar Street 180 HIS IS ISSUED MUST BE STARTED W. Everett,WA 98201 BE DIILIGENTLYYS OF DPURSUED TOATE PERMIT C APLETTION.DTN SEPERMIT M Y Phone:259-8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON T PROJECT OVER 90 DAYS DURATION. \.