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�M� <br /> . 1 �:.::� .. <br /> fi� � • ;5 <br /> �� � <br /> � <br /> ��� � <br /> � _ � _ r <br /> H (A ...:...,. -_r.:�.y.rr.-r:..,.... <br /> H�� - -- - - — --- ---' <br /> � � Date� �"'' � r,or<wa,.,P,�mn. <br /> �il� �il aiao.o�n�.• <br /> yry+ y ApPlicatlon For <br /> p " PUBLIC WORKS PERMIT '°°':w°�„°° S <br /> [q �� Tp��IFee <br /> [� � � I 'laaA00�FelPaiG 5 <br /> Y.� <br /> f;� 9ai�,¢eDue S <br /> �` n Print or Type Only <br /> H <br /> zH <br /> � � �7 Plan Check No: B 27486 <br /> � �N Owner Applicat.Date: 08/OS/^1 phone <br /> Job Addrese: 5618 COMMERCIAL AVE <br /> p Sepa Number: <br /> ��q r Owner: STEWART ER1C <br /> y y Propoeed Use: SINGLE FAMILY RESIDENCE phone <br /> qpplicant Desc. of Work: <br /> �� AD^ ROOM A80VE EXISTING GARAGE & DECK <br /> Describe Proposed Work — OFFICE SBT JOB SET ' <br /> — — APPROVED FOR PERMIT: DATE_/__I_ BY <br /> W ' <br /> Froiect Address(il known) � � <br /> Attach four(4�copies ot plans for proposed work- Draw to scale and note the following as applicable: � � <br /> • PrOperty LineS • C0nI0fIinE OI Sir00t ♦A �. <br /> • Outline and dimensions of all exisling and • Indicate North Vd <br /> proposetl structures on ihe lot • Show any proposed qradinq changes . <br /> �-' �"� • Existing and proposed utilities ' � Show measurements M . <br /> C � W <br /> '�� DO NOT 17AITE BEIOW THIS UNE O <br /> 1 PERMIT CONOITIONS <br /> It.All calls for inspecticn sh��l be made 24 hrs.in advance•phone 259•8810. � <br /> ,_� ' 2.All work shall be peAormed in accordance with this permit and current City af Everett Design and Construction <br /> ��� Standartls and Specificatlons. <br /> �� , 3.Call Location Under9round Service 4B hra beforo you dig.TOLL FREE NUMBER 1•800-424•5555. � <br /> I _ Q ; <br /> �w <br /> �� �j� ' ' <br /> I �� rL��E�.0 cL�l`2/o.y�-,Ln�...���2�� �tC/.�Lfa.a[c7 ' _ <br /> U <br /> �.� � <br /> s1 7,j�i N <br /> i w� ' � <br /> ' !1 1 a <br /> i <br /> I 1 � ACKNOWLEDGEMENTOFCONDITIONS <br /> � <br /> The undersigned owner/applicant hereby agrees to hold and save harm� <br /> - less lhe Ciry ot Everett from any and all claims lor tlamages, costa <br /> expensea or wuses of actlon that may arise because of instal!atlon <br /> � <br /> antl mamtenance ot ihe improvement or other righbol-wey u5e hereto <br /> applied tor and funher agrees to remove same upon notice trom the � <br /> � Approvetl for Construction �a1e C�ty and to replace public property damaged thereby. <br /> , � <br /> . FINAL INSPECTION Da�e <br /> Approved as Conslructetl Signature ol ApPlicant Date <br /> � - WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> ���� PUBLICWORKSDEPAFTMENT I i80 DAYS OF UATE PERMIT IS ISSUED .1ND THEREAFTER IS TO <br /> J200CedarStreet BE DILIGENTLY PURSUE� TO COMPLETION. THIS PERMIT MAY 9E <br /> Everet4 WA98201 CANCELLED BY THE C�N UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259�eB10 PROJECT OVER 90 DAYS DURATIOIJ. <br />