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t <br /> � r�}w�� ...—�` <br /> 9 <br /> e <br /> i <br /> . <br /> ' Guolm wo�ht Permil� <br /> Oate � � <br /> � Biap.Deo�.• <br /> � Applicallo�.� or <br /> PUBLIC WORKS PERMIT PV�TotaFeeFae 5 <br /> � LefaApD�FeePaiO $ <br /> e�ience�ue 5 <br /> ��� Print or Type Only <br /> t�i <br /> x <br /> Plan Check No: B 38215 SEPA <br /> a y y Appllcat.Date: 09/30/92 Zip Phone � <br /> t" � Owner Job Addreea: 4809 COLLEGE AVE . � <br /> Owner: ORMISTON, PATTI <br /> y H Tenant: <br /> K y� Proposed Use: SINGLE FAMILY RESIDENCE <br /> O� H„�� Applicant Deec. of WOrk: Zip Phane <br /> SFR ADDZTION <br /> fA N <br /> � � Descrihe Proposed Wc� OFFICE SET JOB SET <br /> �� APPROVED FOR PERMIT: DATE_/_/_ gY <br /> O H <br /> H �g W�Y (7 <br /> z y� <br /> � H y pwjecl Address(il known) � � <br /> gy H Attach four(4)copies of plans lor proposed work•Draw�o scaie and note Ihe lollowing as applicable: �� � <br /> n d y • Properry Lines • Centerline ol street � � <br /> � �� . � Outline and dimension5 0l all existing and • Indicate North <br /> proposed slruclures on the lot • Show any proposed gradinfl changes <br /> y �y • Existing and proposed u�ilities • Show mezsurements M <br /> W <br /> DO NOT WRITF BEIQV!THIS LINE O <br /> PERMIT COND�TIONS <br /> 1.All calls for Inspection shall be made 24 hrs.in advance•phone 259•8810. �\ � <br /> 2,All work shall 6e pedormed in accordance wilh this permil and currant City of Everelt Design and Constmction ♦ <br /> �'� Standards and Speci�icatians. <br /> .�.,.� 3.Call Location Underground Service 48 hrs.6elore you dig.TOLL FREE NUMBER 1•800•424-5555. � � <br /> i' <br /> /^/-��/ L � � � / O <br /> . / !/CLC<t� C^/LrL il?� �Y)aa-� �� ,C_C�CC.1..�/ , <br /> � �s'� J � <br /> _� . <br /> � /�� ,z -7= ♦/� � <br /> 1 " v+ ' <br /> �� O <br /> �- a <br /> _ _ <br /> 'w �� ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br /> ' less lhe Cily ol Everett Irom any and all claims lor damaqes, costs, <br /> , ' e■penses, or causes of action that may arise because ol inslallation <br /> end mainlenance ol the improvemanl or olher right•ol�way use hereto <br /> applied lor and furlher a9rees to remove same upon nolice irom ihe <br /> ' � Approved for Conslruction Dale City and to replace public property damaged there6y. <br /> FINAL INSPECTION Date Date . <br /> Approved es Conslrucled Signalure ol Applicant <br /> WORK AUTHORIZED BY TNIS PERMIT MUST BE STARTED WITHIN . <br /> ��rL�� PUBLIC WORKS DEPARTMENT � 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS .TO ' <br /> 3200CedarStreol BE DILIGENTIY PURSUED TO COMPL[TION.THIS PERMIT MAY BE I <br /> Evere�t,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phono:259•8870 PROJECT OVER 90 DAYS DURATION. <br />