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� PUBLIC 1� �RKS PERMIT °°''�" <br /> PUBLIC WORKS DEPAHTMENT Publb Nbrkn PermM M <br /> 3200 Cedar Street <br /> Everatl,WA 98201 259•8810 BulWinp Pertntt M <br /> TYPE OR PRINT ONLY Publb Nbrks Fee S <br /> Pl�n Ch�ek No� ! 53087 BiPA pry�e <br /> Owner M ApplLcat.Dat�: 30/01/96 <br /> Job 11ddr���� 1148 b11KEA AVE <br /> Own�rt BLAN K�N <br /> T�n�nt= �� <br /> Applleant M Propoud Uu� BIN6Lt ►AMILY R�BIDtNCt <br /> D��c. of Worki <br /> D IV NAYXIBIILL IN RaOSOM T�ORBLWM�pBTOtt110E — <br /> Describe Proposed Work � <br /> or►tcs aer aos asr � <br /> APPIlOV6D TOR PEAMI?i DJ1T6_/_/_ SY � <br /> _ � <br /> PROJECT ADDRESS(ff known) � <br /> Attach four(4)copias of plu�s la popoaed work-Draw to scals and note IM folbwing M applbabb: O <br /> 'Property Lines �Dutline and dlrtronebne ol ell sxlatinp and propoesd etructuroa on tM bt 'Exlatinp and poposed uUlNlee <br /> 'CenlMins M Mrest 'Indluts North 5how any propoasd yredlnp clwnpes 5how memuremenW � <br /> DO NOT WRITE BELOW THIS LINE <br /> PEFMIT CONDITIONS: Z <br /> 1.All calls for inapection shall be made 24 hours in advance-phone 259-BB10. O <br /> 2.All work shall be performed In accordence with thls pertnit and current CRy of Everett Design and <br /> Constructlon Standards and SpeclBcatlons. <br /> 3.Call Locatlon Underpround Service 4B hrs. before you dig. TOLL FREE NUMBER 1-800-424-6666. H <br /> � <br /> O <br /> �No �ublz Vl�r,�rks p�M,+ a��,� a <br /> � <br /> ACKNOWLEDOEMENT OF CANDtTIONS <br /> Tha undernlqnad ownedapplkant Mroby epren to hdd end uve harmins <br /> ths Clty of EwrMt han eny and all cWms}or darnpss,cusb,�xpxiaes,a <br /> Approved la Conatructlon Date cauass of actbn that mry ariss becws�of Inntdlatbn and melntenenc�of <br /> ths knprovernant a other rlpMrof•wq usa M�Mo applisd lor arW IuMe�proa <br /> to rxmvs sams upon rwtke fiom tM CHy arM to iepl�ce public propMy <br /> dameped thereby. <br /> FINAL INSPECTION Date y' <br /> Approved m ConatniMed <br /> Slpnatura ol Applicant Dete <br /> WORK AUTHORI2ED BY THIS PERMIT MUST BE STAHTEO WITHIN 1B0 DAYS OF DATE PERMR IS ISSUED AND THEREAFfen i3 i0 BE DIlJ6ENTLY PUp3UED TO <br /> COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CI1Y UPON ANY STOPPAGE OF WORK ON THIS PRQIECT OVEH BO DAYS WRATION. <br />