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.��.,v�:� <br /> �.- <br /> � <br /> ,,.:. .:.� <br /> . xs <br /> � �;� <br /> ��,..�� �"� Pub�¢woMs Pe�mit r <br /> Date <br /> oiaq.oeai.. <br /> Application For <br /> PUBLIC WORKS PERMIT Puoi�cWa�kxFee $ <br /> H Total Fee <br /> y � Less AOG�Fee PaiO $ <br /> �� Baianco Dua $ <br /> H <br /> Print or Type Only <br /> 9 Hx fn <br /> H z� <br /> �C y� Plan ChecY No: C 38355 SEPA �p Phone <br /> Owner Applicat.Date: 10/13/92 <br /> � H� Job Address: 8205 FLOAIDA DR <br /> y H Owner: BOND WAYNE L <br /> y Tenant: Pnone <br /> � x� Applicant Proposed Uae: SINGLE FAMILY AESIDENCE p <br /> o Desc. of Work: <br /> O H t7 ADDITION OF BEDROOM� BATH� EXTEND DINING <br /> � ROOM <br /> Describe Proposed Work _ <br /> ��n�" OFFICE SET JOB SET <br /> � y 3, APPROVED FOR PERMIT: DATE_/_/_ BY _ <br /> C+7 �HH <br /> N � <br /> H <br /> n �� Project Address�il known) <br /> r � <br /> � [+7 Attach four(4)copies ot plans lor proposed work• Draw to scale and note ihe tollowing as applicable: � <br /> �,x„� �y • Property Lines • Centerline of street <br /> • Outline and dimensions ot all existing and • Indicate North <br /> � � �� � � � proposed 5trucNres on the lot • Show any proposed grading changi!s <br /> • Existing and Oroposed utilitics • Show measurements M <br /> W <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS � <br /> 1..",II calls lor inspection shall be made 24 hrs.in advance-phone 259-8810. <br /> �`� 2.Ali work shall be performed in accordance with ihis permit and current Ciry of Everelt Design and Construction <br /> '�.� Standards and Specifications. � <br /> 3.Call Location Underground Service 40 hrs.helore you dig.TOLL FREE NUMBER 1•800�424-5555. , <br /> '` ' � O <br /> .r.w�' � <br /> /�L�.S,€aC.. rC�:-Ll.-�1..�_ .,k.� ;�<<r(� /c�`¢c(•:�_ t� � � � <br /> p /�-`/ <br /> . `��.��'n_�.�. � <br /> _� � <br /> �s `f O <br /> ��= <br /> a <br /> �r�-� I <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> � '1 <br /> � The undersigned owner/applicant herehy agrees to hold an save arm• <br /> less the Ciry ol Everett trom any and all claims tor damages, costa <br /> expenses, or causes of action that may arise because of installation <br /> and maintenance ot ihe improvement or other right•ol•way use hereto <br /> applied lor and luriner agrees to remove same upon notice from the <br /> Approvetl for Construction Date Ciry and to replace puhlic property damaged thereby. I <br /> FINAL INSPECTION Date Date <br /> Approved as Constructed Signature ol Applicant <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> �A���� PUBLIC WORKS DEPARTMENT 780 DAYS OF DATE PERMIT IS ISSUED ANO THEREAFTER IS TO . <br /> 3200CedarStreet BE DILIGENiLY PUFiSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Everelt,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS I <br /> Phorie:259�8810 PROJECT OVER 90 DAVS DURATION. <br />