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r. ,�( - . . — .1 <br /> Date 2 12 91 � �����,�.:,v���.<<��,,:,�•,. -------- <br /> Bitlq Dep�.• 91/26928 _ <br /> � n � Applica�ion Por <br /> �� <br /> � � PUBLIC WORK� PERMIT PubbcWoeksFeC S <br /> To�si Fo, <br /> C �„� Less RppL Fee V'ai� S <br /> b H y <br /> r p,inncc ouo S <br /> � � � Print or Type Only <br /> � � M <br /> � 4633 Glenwood Ave. Everett 98203 339-1218 <br /> � Dennis Novak <br /> ro i,�, Owner Maiiing Address City Zip Phone <br /> � � �j Owner <br /> H • Phone <br /> b y � Applicant Mailing Address City ZiP <br /> t+ <br /> M <br /> S y tr Describe Proposed Work COnctYl�t new ao*ch & deck <br /> n O N _ <br /> o�ar <br /> � � � � <br /> Prolec�Addmss�if known) 9633 r'1� �'Ood AVe. � <br /> � <br /> tdtach lour 1�1)copies of Plans for proposed work� O�aw�o scale and note the�ollowing as applicable�. � <br /> • Property Lines • Cenlerline ol street <br /> • Outline and dimensions of all existinc�and • Indicate North <br /> proposedslrucWresonthelot • Show any proposed yradmg changes <br /> • Existing and p�oposed utilities • Show measurements M <br /> W <br /> �O NOT W(71TE BELOW THIS LINE O <br /> PERMIT CONDITIONS � <br /> 1.All calis lor inspection shall be made 24 hrs.in advance-phone 259-58�0. <br /> i'� ��� 2.All work shall be pedormed in accordance with ihis permit and current City ol Everetl Design aod Construction <br /> Standards and Specilications. � <br /> � 3.Call Location Underground Service 48 hrs.belore you dig.TOLL FREE NUMBER 1•800•424•5555. <br /> � ��C'/F/L LU�GCC.IhI L2�,t � ����_ I7'Ll�.�A '�'�E� O <br /> �� !�I .� �GUIh�jC.a� ��0� • �''7�/LC�(Xo. K bL'�('v�".. _ <br /> ' �iu �Ln P <br /> �{�a�b,-' �Q•t/rm� Lt� �ie /tP�.Ut�+.c �,� S�cc�/� <br /> �za�v �w ��f�w ,co �o ���t .�n.t cv�.. ♦/� <br /> � ��� .S.ec�,,� ' V♦ <br /> ! ��/ d�'�,.,, �°/rX��a-,w� �+'')CN/LcQ' �' O <br /> _ .//�e .S.caL�v��Co-�e' �ze� ,6� -C�aed' �CrL w S.e��°-Z't/ ^ <br /> , !.1 1 �r-u'� � ha.�c -� oz� `�sJ�d�-��,.�-� �� <br /> �� Se�,�,« ��a,��J- ,/y,��'�i%�UT �.E�l Ui�'�D �; /3'9 / <br /> � ��L' (��'f / ACKNOWLEDGEMENTOFCO ITION� <br /> !1�� � �U� The undersigned owner/applicant heret�y agrees lo hold and save harm- <br /> I less ihe Cdy ol Everelt I�om any and all claims tor damac�es. cosis. <br /> ezpenses. or caus's ol aclion thal may arise because ol inslallation <br /> and maintena�ce ol the improvement or other �ic7hPo4viay use hereto <br /> ' '�' applied lo ,nd lurther ac��ees W remove same upon notice irom Ihc <br /> qpproved br Construclion �a�e Cily and o r�place public properly damage lhereby. <br /> FINAL INSPECTION Date � p��� <br /> ApProved as Constructed Signalwe o App im <br /> WORK AUTHORIZED BY THIS PERMIT MUST 8E STARTED WITHIN <br /> everet� PUBLIC WORKS DEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEFEAFTEii IS TO <br /> � 3200CedarSlreet BE DILIGENTLY PURSUE[� TO COMPLETION.THIS PERMIT MAY BE <br /> Evcretl.WA 98201 CANCELLED BY THE GTY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259�8810 PROJECT OV[R 90 DAYS DURATION. <br />