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Date 5/19/93 TO POSTING_ iz-8-9� <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type On!y <br />P�plic Worke Permi(,so J .J � 3 <br />BIEp. DeDI. e 4 <br />Pu4Lc Works Fee <br />Totei Fee : <br />�eae �p0�� Fee PeiE 5 y� <br />BLance Due S �✓C' 3 � <br />Everett School District 4730 Colbv Ave Everett 98203 339-4226 <br />Owner Mailinc� Addresc City Zip Phone <br />Alternative High School <br />Describe ProposeA Work <br />Project Address (if known) <br />Mailinq Address <br />3516 Rucker Ave <br />3516 Rucker <br />City <br />Renovation <br />Attach tour (4) copies o� plana for proposed work - Draw to scale and note the following as applicable: <br />• Property Linea <br />• Outline and dimensions of all existing and <br />proposed sVuctures on the lot <br />• Exiating end proposed utilities <br />� Centerline of street <br />� Indicate North <br />• Show any proposed gredinp chenges <br />• Show measurements <br />PERMIT CONDITIONS - <br />t. All calls for inspection shall be mede 24 hrs. in advance • phone 259•8870. <br />2. All work shall be performed in accordancn with this permit and current City of Everett Design and Construction <br />Stenderde and SpacNlcations. <br />3. Call Locetlon Underground Servlce 48 hrs. beforc you dig. TOLL FREE NUMBER 1-800-424•5555. <br />. � — -- — <br />Ctl`�� Lt�02� .Z�o � cY0)'t2 <br />�./�aJ C ulilv.ct PG'�Qcc� LU� <br />n�g��� <br />tJ ' <br />JUL 281993 <br />............................... <br />CITV OF EVERElT <br />Building Divis�on <br />�2 �a-�vi 4,a�D'1.�.// (J <br />/ <br />� �� m�. 'J-3a-93 <br />�2�' �07�2 7 .3 � <br />Approved for Co tr �on te <br />i� isy si <br />FINAL �NSPECTION Date <br />Approved as Constructed <br />�PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everatt, WA 98201 <br />Phone: 259•0010 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />� <br />� <br />� <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold anA save harm� <br />less the City of Everett from any and all claims for daiiages, 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 />applied br and further es to remove same upon notice irom Ihe <br />City and tacr e p lic pr pert maged thereby. <br />Signature oi Applicant Date <br />WORK AUTHORIZED BY THIS PERt�iIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERM�T IS �SSUED AND THEREAFTER IS TO <br />BE UILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 OAYS DURATIOtJ. <br />