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Date 2-11-92 ' � weMwe,..v..m��. <br /> ApplicallonFor eiaoow�.• Q��-�5613 - <br /> PUBLIC WORKS PERMIT °�°:;,:�::�•• . <br /> L+a�oo�h�vue� <br /> e.ianc.Ju. S_ <br /> Print or Type Only <br /> Raleigh Johnson 4903 Fowler Ave Eveett 98203 252-5938 <br /> Owner MeiNnq ACEress Ciry Zip P�one <br /> DeWi[t Conetruction 3225 139th Ave NE Lk Stevens 98259 334-7404 <br /> AppliGanl MaillnqAtltlress Cily Zlp P�one <br /> OeacrieePr000seeWork bathroom and aaraRe addition [o SFR <br /> u <br /> Project AECress�il known) � <br /> Atl�c�lour 1<)copiea ol plana lor pro0esetl work•Oraw lo scale antl nate t�e lollowing as applicable: � <br /> • Pmperry Lines •Centeri�ne ol strect /' <br /> •Outline anA tlimensions ol all ensting antl • Ina�wte Nort� V <br /> propaSeC atrucluree on Ine lol •Snow any proDosetl gratling cnanges <br /> •Eaistinq enE O�opoae0 utilitiea •Show measuremenls O <br /> DO NOT WRITE BELOW THIS LINE � <br /> pERMITCONDITIONS <br /> 7.All ulla lor Inapactlon ahal�De matle 24 hrs In advance•p�one 259-8810. � <br /> p,All vrork a�ell Ee DeAormeE In accortlance with I�la permit ond cunent City al Evarett DeeiBn and Constructlon <br /> stenaeMa ena sp«illntiond � <br /> &CaIlLocatlonUnderqroundServite4B�rs.DetareyouOip.TOLLFREENUMBEPI-800-424•5555. � <br /> � <br /> C <br /> ,C��7 , � F <br /> / (/�j'L L✓:� r��rlC� �Eh71/�y,ccN�a�� /� <br /> � e H <br /> �b C <br /> � -//-9 z /� <br /> ` <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> T�a un�erslqned Owner/Bpplicent�ereEy a0rea9 to�oltl end save�a� <br /> less t�e City ol Everelt Imm any anE all cleims lor CameOel cw <br /> �Bxpemex or Causea ol eCllon t�al may eriae beCause ol Inelalleti <br /> enC mainlenance ol t�e Improvemenl or ottler ngM�ol•wey use hen <br /> eOGIIeC br and lurtner epreea t0 remove aame upan notite Iram I <br /> ApOrovsC lor Conatrucllan Dete Cliy and Io reP�atB OubliC prOPBriy OemeqeE I�ereCy. <br />'FINAL INSPECTION Date <br />,ApproreE es Conatruat�E SiQneNro ol Ap0licant Date <br /> VUBLICV/OFNSDEPARTMENT WORK AUTMORIZED BY TMIS PERMIT MUST BE STARTEO WITM <br /> I� 3200C�GrdtrNt 180 DAYS OP �ATE PERMIT IS ISSUED AND THEPEAFTER IS ' <br /> Ev�ntt WAYl201 BE DILICENTLY PURSUED TO COMPLETION.TMIS PERMIT M�Y I <br /> Phone:25FeE10 CANCELLED BY TNE CITV UPON ANV STOPPAGE OF WORK ON TF <br /> PROJECT OVER 90 O�VS DURATION. <br /> L <br />