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� � <br /> �a�e yiplie WorM�Permit I <br /> Applicalfon For mno�oom.. <br /> PUF3LIC WORKS PERMIT P����=Wa�k,F.. — <br /> Totnl Fae $ . <br /> Les!�OGI Fee P�iC $ � <br /> Print or Type Only Pian Check No: B 45303 SSPA e.�.��.o,,, s <br /> Applicat.Date: 08 17/94 <br /> Job Addreee: 81 9 FLORIDA DR <br /> Owner: TROWBRIDGE REN/LINDA <br /> Tenant: <br /> Propoeed Uee: SINGLE FAMILY RESIDENCE <br /> � Owner Deec. of Woek: �ip Phone <br /> FAMILY ROOM ADDN <br /> OFFZCE SET JOH SET . <br /> Applicant '_iP Phone <br /> � APPROVED FOR PERMIT: DATE_/_/_ BY <br /> 'Describe Proposed Work _ <br /> �� <br /> -----���_--.�----- w . <br /> �ProjeclAddress(if known) L <br /> i4�teCh fOU�(4)COpi05 O� p1an5 10�prop050�wurk� Drl1v� to sr,ale�nd ncie tha foilcwing as applicable: � <br /> • Property Lines • Centerline of street /w <br /> • Outline and dimensians ol all exisling and • Indicate North V, <br /> , proposetl structures on the Iot • ghow any rroposeA grading changes <br /> • Extsttng and proposed utilities • Show measuremenls � <br /> � DO NOT WRITE BELOW TH�S IiNE <br /> i PERMITGONDITIONS O <br /> ' 1.All calls for inspection shall be made 24 hrs.in advance•phone 259•8810. � <br /> r� 2.All work shall be performed tn accordance with this permit and current Ciry of Everetl Design and Construction <br /> Standards and Specifications. <br /> � 3.Call Location Underground Service 4B hrs.before you dig.TOLL FREE NUMBER 1-800•424•5555. � <br /> a � <br /> PUBLIC WORKS PERMIT � <br /> NOT E�UIRED ♦/� <br /> V♦ <br /> � av q � <br /> i UATE <br /> � <br /> a <br /> � <br /> I ACKNOWLEDGEMENT OF CONDITIONS <br /> i � The undersigned owner/applicant hereby agrees to hold and save harm- <br /> � � less Ihe Cily of Everetl irom any and all claims br tlamages. cosls. <br /> �, � exp¢�nses. or causes of action that may�arise because of installation <br /> �. � antl mamtenance ol the improvement or other�ighbof-way u_e hereto <br /> appl�ed for and further agrees lo remove same upon notice from the <br /> �broved for Construction Da�e I Ci;y and to replace public properry damaged thereby. <br /> I <br /> i <br /> 7AL INSPECTION � Date <br /> iroved as Constructed Signature ol Applicant Dale <br /> � PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CedaiStreet • 780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Phone:259•8870 CANCELIED BY THC CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 �.�YS DURATION. . <br />