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%`- <br />TYPE OR PRINT ONLY <br />Applicant <br />PUBLIC 11�RKS PERMIT <br />�a������ <br />���� <br />EvxMt. WA 98201 269-8010 <br />Dexribe Proposed Work _ <br />PROJECT ADDRESS (if known) <br />Plan Chock Noo C 56672 <br />11pp11cat.Datat 10/03/�7 <br />Job Addrae�s 6315 4i BEBCH 8T <br />Oian�ri DEFORD JOHN <br />�,.� <br />���.�. <br />BuYdrq P�rmlt • <br />PuhYc Wbrla Fa� t <br />BEPA <br />Tenentr <br />Propored Uao� SZN6LE P1IMZLY R88IDBNCS <br />Daec. of Work� <br />BATHROOM ADDITION <br />OPFICE 8ET JOB <br />APPROVSD FOR PBH!lITt DATS_/_/_ BY <br />PIIOM <br />Phorb <br />Atluh four (4) eopbs of plens }or propossd woAc - pra�, to ecW and nob ths }olbwlnp H applkabla: <br />'Propsrty Llnss �Oulllns end dimanebne ot ell exittinp and propo�ed stnicturos on tM bt 'EaM4q rM prq�paad WII%les <br />'Centerllno ol atrost Nndiuts North 5how anY propcaed Oradtrp chenOp �$fq�y ����ta <br />- - ...._ �.'_ <br />PERMIT CONDITIONS: <br />1. All calls for Inspectlon shall be made 24 houra in advence - phone 259-8870. <br />2. All work shall be peAormed In accordence wRh thls permit and current City of Everett Design and <br />Constructlon Standarda and Speciflcations. <br />3. Call Location Underground Service 48 hra. before you dig. TOLL FREE NUMBER 1-800-42{-6666, <br />Approved lo� Constrvctlon Date <br />FINAL INSPECTION Date <br />Apprcved ae Conatrueted <br />pUYL1E WO�Ks �&��� <br />Nor OUIREI <br />av._,�„�i.— <br />MTE�_��� <br />---._ <br />W <br />H <br />� <br />� <br />� <br />� <br />O <br />a <br />ACKNOWLEDOEMENT OF CONDIT10N3 <br />Ths undersipned ownsdepp4cent AxWy prsa to laa rM aw IwmNes <br />tha Cky ol Ewrery hom erry �nd �p cWme far demepse� cwu� exp��� a <br />uusea of actlon that may aAas becaus� of k�stdletWn �nd rtulnt� of <br />tM ImF�overrwit a wher riphtcl-wry uw h�eto appled tor and turtMr �pws <br />to romovs same upon rwtks hom ths Cly and to �spl�ce puypo propMy <br />damaped thereby. <br />Slpneturo ol Applkant p��e <br />WORN 4UTHORIZED BY THIS PERMIT MUST BE STARTEO WfTHIN 180 WYS OF DATE pERMR IS ISSUED AND THEREAFiER IS TO 8E qLIOEPRLY PURSUED TO <br />COMPL.•TION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON NVY STOPpqpE OF WOpI( pN THI3 PfiOJECT OVER YO pAYB WRATION. <br />