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.. ._.-cv I . _. . <br /> i: <br /> • <br /> I <br /> �, <br /> . .. ,_. �....., i <br /> Date 11/12/92 I a�ci��wo,.�v��m�i. _ _. _ <br /> eiac.oeo� , 38687 <br /> Applicalion Fnr � <br /> PIJBLI� VI/ORKS F'ERMl�' P°°r°,aFeeFec g � <br /> Less R:c� Feo Paa 5_ ! <br /> S <br /> H O FI Baianco nua 5_ , <br /> ��"� Prinl or Type Only <br /> A�x <br /> y y� Leibsohn Boguch 5 Co 11100 8th St 11800 Bellevue 98004 448-%609 (Tenant: St Vincent DePaul) <br /> H xy 3 Owner Mailing Address City Zip Phone <br /> H xH <br /> �C C] <br /> '�� David Murphy (architect) 448-2690 <br /> "��C H� qpplicant Mailing Address City Zip Phone � <br /> VJ H <br /> �jz T.1. <br /> H <br /> L" y d Desr.ribe ProposeC Work — � <br /> OH <br /> H �g — <br /> c�• n � <br /> zH� <br /> H �H H Project Address lil Lnownl 5319 Evergreen Wy SG <br /> N <br /> H Atlach four�4)copics ol plans for r.roposed work- Draw to scale and nole ihe lollowing as applicable: � <br /> n d y • Centerline ol sireet ♦A <br /> G C r • PropertY Lines <br /> � t`� • OuUine and dimensions of�JI exisPrg and • Indiwte Norih V� <br /> C+7 h] <br /> z y q7 ' proposed strudures on the lot • Show any proposed grading changes <br /> H O!/� • Existing and proposed utilities • Show measurements M <br /> W <br /> DO NOT WRITE BELOW THIS LINE O . <br /> PERMIT CONDITIONS <br /> 1.All calls tor inspection shall be made 24 hrs.in advance-phone 259•8810. � , <br /> j 2.All work shall be pedormed in accordance with this permil and current Ci�y of EvereQ Design and Construction <br /> Standards and Specifications. . � <br /> f�"�' 3.Call Lcca�ion Underground Service 48 hrs.belore you dig.TOLL FREE NUMBER'I-SOO•424•5555• � . <br /> �� <br /> I� `_�i O <br /> �� � <br /> PUBLIC WORKS PERMIT I � <br /> !�.�,. NOT . EOUIRED� <br /> �� BY � /� <br /> DATE /f/(<- /`2 \�. , <br /> „� 1� <br /> "'�'� ACKNOWLEDGEMENT OF COIJDITIONS <br /> The undersioned owner/applicant hereby a�rees lo hold and save harm- .� <br /> �.� � less the City ol Everelt trom any and all claims lor damages, costs, <br /> � � expenses, or causes of action that may arise because ol installation <br /> and maintenance ot the improvement or other righFoFway use herato <br /> applied tor and lurther a9n:es lo remove same upon notice imm Ihe �� <br /> � <br /> � Approved for Jnnslruction Date City antl to replace p�.blic properry damaged ihereby. '� <br /> FINAL INSPECTION �a�e —'— Date � � <br /> Approved as Gonstructed Signalure ol Applicant <br /> WORK AUTHORIZED 8Y THIS PEFMIT MUST BE STARTED WITHIN , <br /> �� PUBLICWORKSDEPARTMENT 180 DAYS OF DATE PEFMIT IS ISSUED AN� THEREAFTER IS TO <br /> 3200 Cedar Strael BE L4UGENTLY PUNSUED TO COMPLETION.THIS PERMIT MAY BE i <br /> Everelt.WA 98201 CANCELLED BY THE CI7Y UPOPI AN��STOPPAGE OF WORK ON THIS �� � . <br /> Phone:259�8870 pROJE:'T OVER 90 DAYS DURATION. <br />