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�� � <br /> n� x <br /> C H <br /> H W 7-31-91 r""1 P"'• v�w�owo.k.r�,mn. _ <br /> H Z� Date ' nma occ� . 91/%Y37[8 27454 <br /> Application For <br /> K <br /> y y PUBLIC 1NORKS PERM �T '�°°'�°w°.'�`°° <br /> O x O iobl Poe s— — <br /> 'y I"I -y lP3i<O(�I GC!F��E 'S <br /> VJ M <br /> ��� Bnianrr Oue S <br /> Print or Type Only <br /> OM <br /> � � " HUL YANG PARKS 5729 BROADIv'AY EVERETT 98203 776-5209 <br /> p` r Owner Mailina Adtlress CAy Zip Phone <br /> yH <br /> zH <br /> r �,.�y Owner <br /> gy Applicant Mailing Addrr,ss City Zip Phone <br /> N <br /> n�N <br /> !q Describe Proposed Work Storaqe addition to SFR. 335 SF <br /> H fn <br /> H O V� <br /> - W <br /> Project Address Iif known) S�Z9 BROADi4AY -- � <br /> Altach�our(4)copies ol plans lor proposed work- DraH•lo scale antl note ihe lollow�ng as applicable �� <br /> • Property Lines • Centerline ol streel ,^ <br /> • Outline and dimensions ol all existing and • Indicate Noith V� <br /> proposed slruclures on ihe lot • Show any proposed gratling changes <br /> • Existing and proposed ulilities • Sh�w measuremeNs /y� <br /> W <br /> DO NOT WRITE BELOW THIS LIN[ Q <br /> / � -�-�� PEFMIT CONDITIONS <br /> (�� �� 1.All calls for inspection shall be made 24 hrs.in advance-phone 259•8810. � <br /> � �, 2.Ail work shall be pedormed in accordance with this permit and curreM Ciry ot Everetl Design and Constructicn <br /> , � i Standards end Specilications. <br /> 1 � 3 Call Localion UndPrground Service 48 hrs bebre you dig TOLL FREE NUMBER 1•BOO•424•5555. � <br /> � O <br /> �' � , <br /> I � ���.fc(�G LLC�]'G✓�t:.2in� � �Jt' •�ly�C�(iFt1' <br /> �l �� / <br /> , 9�i�.";��-`����� �.., <br /> � a-� �;/ ♦A <br /> �� V+ <br /> ����� O <br /> i a <br /> ( ��� � ACKNOWLEDGEMENTOFCONDITIONS <br /> 1 <br /> The undersigned owner/applicant hereby agrees to hold and save harm� <br /> less the City ol Everell irom any and all claims tor damages. costs <br /> eapenses, or causes ot action Ihat may arise because of inslallation <br /> ��, and maintenance of the improvement or other righ4ol�wey use hereto <br /> applied for and lurlher agrees to remove same upon notice irom Ihe <br /> --� Appmve0lor Construction Date City and to replace public property damaged thereby. <br /> FINAL INSPECTION Date — <br /> Appmved as Constructed Signature of Apnlicant Date <br /> y � _: WORK AUTHORIZED BY iHIS PEP.IAIT MUST BE STAiiTED WITHIN <br /> _ PUBLICWORKSDEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> i � 3200 Cedar Street BE DILIGENTLY PURSUED TO COMPLETICN.THIS PERAfIT MAY B[ <br /> �i - Everati,WA98201 CANCELLED BY THE CITY UFON ANY STCPPAGE OF WORK ON THIS <br /> Phone:259�8810 pROJECT OVER 90�AYS DURNION. <br />