Laserfiche WebLink
a_ <br /> �c��+ � <br /> t .�-zo -zg-s" °lu ,►2�s� ( <br /> �,.,,,�w�,�,�.,m„. <br /> Av�� Date_��`lG .d-�-j J <br /> oina oen� • __—y-Q <br /> y Ij N APPlirn�ion For '____" <br /> y �� PUBUC WORKS PERMIT °°""`"'°,"`"° s—�� ��- <br /> ,�,.,«� <br /> � �C'1 i.��Ann r.e vma S =j�-- <br /> � /�/(� <br /> fJ Fla•:.��.D��. S �L T—i�—. <br /> �y � Prin� or Type Only <br /> HC� (� G Q/ ,/ /� (�n (�� <br /> O^�~ �y S 7 � /JSS� �D�J .S� ! tlt~ ���,� P �U/Y' 7V �� Y 7� 7 –Q�P�ne <br /> M IO O Owner Maihn9 AAAress CdY Zip <br /> pw � j � J �� <br /> � H� � ��-5"r'iQ� �5114�«�-�--'u`��]�_411�Uti�-5���-� -- I <br /> t� q IlCenl MailinB Address City T�p P one <br /> M n (��� � � <br /> y ��"',, 1� I ��U-I��+�W-�- f�'N--"-i 1-Q I <br /> g �� � -------U� � / ' — i <br /> Desr,ribe P�oposed Work _.�y.CL�—�+� � <br /> ��� _ -- -- ____ W ' <br /> Prolect Address lil knownl <br /> oZ-`�7-� G�a2 ST ___ — � <br /> � <br /> Allach lom(4�cnpies o�Plans br propo5ed work� Draw lo scnle antl nole the lollowing as appii�'abie. � <br /> ! Property Lines • ConletlinP, o�strrNi � <br /> • OuUine nnd dlmensions o�aU e.isting and • InAiwlr Noith � <br /> proposed sbuclu�es on the lat • Show nny piopnsrA 9nitlin{�chany��s <br />. • Show measuminrnrs M <br />� • E�is�ing nnA proposed utildies W <br />. DO NOT Wf7liF BGLOW TNIS LWL O i <br /> PERMIT CONDITIOtJS � <br /> 1,All cells lo�inspect�on shxll be made 24 hrs in advance-phone 259•8810 <br /> /� 2.All work shall be pertormetl in eccordance with Ihis Dermit and curtent Cdy o�Evrret!Cesign nnd Construcfion <br /> � Stenderds nntl Specilicelions. <br /> , �� 3.Call Locetion UnAerg�ounA Service 4B hrs.belore you dip.TOLL FREE NUMOER 1•800•424•5555. � <br /> 1 � 7 ��/t'(iv�� �:�"f .S - Z�� -�� U � <br /> �� �- /;Gv c <br /> I r <br /> , � f17/;L' '.0 ; :O1�M UtlJ1t12506 � <br /> i OA00(l'.0691 <br /> qD0006460 A <br /> � pF'l.�u ^64.r,0 li■ <br /> '� ��� FW PC 4194.01 <br /> FWINSF` i1212.5� <br /> HFCY. SI491.1e <br /> ACY.NOWIED�EMENT Of CONDITIONS <br /> I "� The undrtrsiqneA owner'apphcnnl��eicby ep'ees lo ho'A:�nd save harm� <br /> — less the Ctly ol EvnreO Irom �ny and all clalms lor damages, costs. <br /> � eKpenses o� rauses r,l acUon ihal mny an5e becNuse, o� �nslnlla�ion <br /> J ��` �anA ma�nlennnr�� nl thr imprnvement or othnr n9hl�ol�wny usr heieto <br /> ��,' � t� � -��% � � ��ppli� loi and �ui�hrr n9re�e to remove same upon notice Irom Ihe <br /> ��' A roYetl lor s .lio�' / �te Cd an� to ir la . ��:N P�' Y c i n� . •reby <br /> ' �'� � :.�- �-�� z- <br /> < <..-;� /D-� <br /> o,ie - - „ - - -- <br /> FINAL INSPECTION S n e 1 APV��r� t Oate <br /> Appmved as Co�slrucletl <br /> WORK AUTHORIZCD iH15 PERMI7 MUS1 F�E SiARTED WITHI <br /> 0��vrrrll PUBLICWORKS�CPARTMENi 180 DAVS OF DATE PGRMIT IS ISSUE� AND THEFEAFTEF �5 TO <br /> 3200CedarSbect BE DILIGCNTLV PU(iSUE� TO COMPLETION THIS PLRMIT MAV BL <br /> Everell.WA�N201 CANCELLED PY THE GiV UPON ANY STOPPFGE OF WORK ON THIS <br /> Phone�.25�J�BB10 P[70JECT OVER ��� �AVS DU�ATION <br />