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� ,- � . <br /> �"�O - - <br /> n� z - _ _ -. -- ' <br /> � '3 f� :."r rf <br /> H �� Date o�owcwo��o«mn• <br /> F3 H B�ep Oeot• <br /> 4ppliteM1o�For <br /> ��� PUBLIC WORKS PERMIT °°°�w.M`°° s <br /> V1 H <br /> �] �� Lest/.00I fea P�ro s <br /> c9.unce ove S <br /> OH <br /> d Pnnt or Type Only <br /> � � � Plan Check tao: B 27426 <br /> p` n Applicat.Date: 07/26/91 <br /> hy Job Addre: 2214 DRCADWAY Z�p phone <br /> s H Owner Sepa Number: <br /> r� Owner: DEROUIN ROY <br /> H �-7 Propoeed 'Jse: RETAIL / APTS <br /> �y Desc. of Work: <br /> ~ AEPAIR FIRE DAMAGE — REPLACE ROOF <br /> �y hpO��Cent ZIP PhOne <br /> Hfi�� OFFTCE SET JOB SET <br /> y "" DescriDe ProGoseC N� ` <br /> y �� ApPRVD FOR PEAMIT: DATE_/_/_. BY. <br /> � <br /> Prolect Address(��k�o'�'^) � <br /> Atlach low(dl�OP�as o1 plans�or proposed work-Draw to scale and note Ihe�o�lowing as applicabie: �� <br />� • Property L��es • Cr.nterline of 5treet ,^ <br /> • Outllne antl dimensione of all ex�sting and • Indiwte North V� <br /> D�opoeed struCtWes on the lot • Show any proposed gradmg changes <br /> • Exlsting and pro�osed utilities • Show measuremems /M <br /> W <br /> DO IJOT Y'.NITE BELGW THIS LINE O <br /> t r��' PERMIT CONDITIONS <br /> f ` t.All caHs tor inspection shall be made 2<hre.in advance•phone 259•8810. � <br /> � , 2.All work shall be p?drnmed in accortlance�!ith this permit and current City of Everetl Design and Construclicn <br /> Slandares and Spacillcations. <br /> , � 3.Call Locatlon Untlerground Service a8 hrs.belore yo��+ig TOLL FREE NUMBF.R 1-800-4245$55. � <br /> ' � O <br /> � � - -;� �� � ." � <br /> � ��L�J-UG Lvcr� "" ��-l�'�.�� �� � � � <br /> ra �� '/ ' � <br /> ; �1_� �� � J <br /> � <br /> II �`1 4CKNOWLEOGEMENT OF CONDITIONS <br /> I7he undersigned ownedaoolica�t he�eby agrees to holtl antl save harm� <br /> ,_,_. iess the City ol Everetl trom any and all claims for Camuqes, costs. <br /> L1� ex0enses, or causes ot ac[ion that may anse because of �nstallation <br /> � and maintenance of the improvement or other nghPol-way ur.e hereto <br /> appliad �of and lurihef agi009 10 rRmove Same upon no�iCe 1rOm Ihe <br /> �pOrovetl fOf COnSIfUdiOn DBIB � Ci�y 0ntl t0�ep1aCB pub�lC Oroperty tl0magetl �hefeby. <br /> � <br /> � <br /> =1NAL '�NSPECiION Da�R I <br /> 4pprove4 as CJnsiructetl I Signalure of Applicant Oate <br /> � WORK AUTHORIZED 9V �fH15 PERM�T MUST 9E STARTED WITHIN <br /> � �UBLICWORKSDEPARTMENT 1gp pqYS OF DATE PERMIT IS iSSUED AND TNEREAFTER IS "O <br /> 3200CetlarSireet 9E DILIGENTLY PURSUED TO COMPLETION. THIS PEPMIT NAV 9E <br /> 'everetC WA 98201 �ANCELLED BY THE CITY UPON ANV S`OPPAGE OF WORK ON THIS <br /> Phone:259�9810 �qOJ[Ci OVER 90 DAYS DURATIOlJ. <br />