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_ �� <br /> � ' �� <br /> ���q . . _ ..o.�; <br /> , A � <br /> ��� �8�0 6/�5/90 F V � Puolmwmbpermit• <br /> � APv��catlon For Biap O�oi . 90/29?48 <br /> ��� PUBUC WORKS PERMIT P�����W^,�.�.. <br /> � to1�IF�� f <br /> � leu 11pp1 F�a P�id f <br /> � � B�Imo Oua f . <br /> Print or Type Only <br /> �pp Buza s C�rol Rodland 510 Alverson Blvd. E��erett 98201 258-1077 <br /> O• <br /> � Owne� Malling Addrass Cny Zip Phone <br /> H <br /> 1-1 Patricia Grennan Deaigu 2618 Eastlake Ave E. Seattle 98102 328-2886 <br /> G� Applleanl Mailing Addreas C�ty Zi0 Phono <br /> �� �eacribe Proposed Work Small addition & Kitchen Remodel <br /> W <br /> . Pro�ect Addrees lil known) 510 Alverson Hlvd. � <br /> Attach lou�(4)copiea ol plans lor propoeed work• Draw to scale antl note iha tollowing as eppliceble: � <br /> • Property Linea • Centerline ot streel � <br /> • Outline anO dimenalons ol ell existing antl • Intlicale Norih <br /> , propoaed etructures on the lol • Show eny proposeA gratling changos <br /> ' • Exlsfing end p�opoaed ulllities • Show measuremeNs � <br /> �O NOT WRITE BELOW THIS LINE O <br /> _-.,� PERMIT CONDITIONS <br /> -�� 1.All Cella lor Inepectlon shell be made 24 hra.In advance•phone 259•$8�0. � <br /> 2.All work eha:l be peAormed In eccortlance with thle permit entl current Clty ol Everett Design and Conetructlon <br /> { Stenderd6 and Specllicallone. <br /> i3.Call Locatlon Underpround Senice 48 hrs.belore you dip.TOLL FREE NUMBER 1•800•424•5555. � <br /> C� / L'�<f Cs�o/'��c''Yl�u f .���� ��G•c 1cr� � <br /> i � �. � <br /> i <br /> i���, . f��-- <br /> '� ��' � ,�� -�� � <br /> I 0 <br /> � -- a <br /> li +� ACKNOWLEDGEMENTOFCONDITIONS <br /> ; The undersigned owneqapplicant horeby aprees lo hold and save harm� <br /> less the City of Everolt Irom any and all claims br damages, costs, <br /> � e.penses, or causes o� action that may anse because ol Inslallatlon <br /> � and mainlonante ol the improvement or other ngh�•ol�way use herelo <br /> upplied lor and lurlher agiees lo remove same upon nolice Irom Ihe <br /> , Approved lor Conelruclion Date Clly and to rPplace publlc proPer�Y damegad t�ereby. <br /> FINAL tNSPECT10N Onte <br /> Approved es Consiructed Siynature ol Appl¢ant bate <br /> everett PUBLICWOqKSDF.F�ARTMENT WORK AUTHORIZED BV THIS PERMIT MUST BE STARTED WITHIN <br /> � 3200CedarStreel 180 DAVS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everelt,WA98201 BE DILiGENiLV PUfiSUEO TO COMPLETION. THIS PERMIT MAV BL <br /> Phone:259�BBt0 CANCE�.LED BY THE CIiY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER�JO DAVS DURATION. <br />