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ERM�T Date <br /> �'�;auon Po�� � <br /> pUgLIC W JRK Public Works Permit u f <br /> � PUBLIC WORKS DEPARTMENT 8uildin9 Pertnit N <br /> 3200 Cedar Slr Z59-8810 <br /> Everett.WA 98201 <br /> public Warks Fee 5 <br /> 1YPE OH PRINT ONLY SEPA <br /> Phone <br /> plan Check Np0 p5%12I97 <br /> M� pppobcAaares8: 1015 CRORVING & BETTY phone <br /> �W�e� 1 pwner: VARLEY � <br /> propoaednUse: SINGLE FAMILY gESIDENCE <br /> � M� of Work�ADDITI�N � <br /> FPPlicant Deec. gATH <br /> BEDROOMI - �� <br /> Jpg SET /A <br /> osed`No�k � oFFICE SET- �� BY� \I� <br /> pescribe ProP ppTE�/� <br /> APPROVED FOR PERHIT: � <br /> it app���able: �o osed ulilities O <br /> ESS(if knoW�) note the followi�9 •Existing and p P <br /> PROJEGT ADDR Oraw to sca�e and structures on the�oi <br /> for roposed W�'rk- and proPosed �ShoW measuremenls � <br /> q �opies ot plans P radfn9�hanges <br /> pttach four l) w�t��ne and dimensio��s°���Show 1a Y PfOPosed 9 �INE <br /> •ProPe��ines ELOW THIS O <br /> �Centerline ot streel '��d��e�e NoM1h <br /> DO NOT WRITE B 8810. �and <br /> 4 hours in advance - phone 259- of Everett Desig <br /> pERMIT CONDIT��NS: ade 2 ermit and current City 424-5555. � <br /> ection shall be R' REE N�MBER��g00� ♦^ <br /> � A���a��s{or insp erformed in accordance with this P TOLI.F <br /> g ecifications. ou dig• V/ <br /> 2. All work shall be P ery1Ce 48 hrs.before y O <br /> Construction Stnde gdoUnd S P ' <br /> 3 �a���ocation� � <br /> � � ����4 � 1' �t,t 1`� ��j��� <br /> �1b I�u�l ��. �-- <br /> WLEDGEMENT OF GONDIT��NS <br /> ACKNO � rees to hold and save harmless <br /> lor damages•�osts,ezpenses�a� ;nr.� <br /> The undersi9ned ownerlapP�icant herehy 9 a���enance of <br /> of Everett Irom anY and all claims <br /> that may arise beceuse o�inslallaU�'o�a�d��hher a9��5 <br /> the City a usehereto app u61ic PfO�jerty <br /> causes of action h�.ot•w Y and to rep�ace P <br /> �he imProvement or oo e^o Ice Irom lhe City <br /> pate to �emove same up <br /> dama9ed therehY� <br /> APPfOved lor Construction pate ' <br /> Date <br /> licant �pSUED T� <br /> Signature of ApP �`q�S T�gE DILIG�N�NY P <br /> FIPIAL INSPEC710N THERFl� <br /> qPproved as Constrocted �y TNIS PR��E�7�VER 9��AYS�U� <br /> Y THE CIiY UPON ANY S70PPAGE OF WORK <br /> IZED BY THIS PERMIT ANGEBLEDT8R7E�W�THIN 18�OAYS OF DA7E PERMIT IS�SSUED AN <br /> W�AK AUTH� TF11S PERMIT MAY BE C <br /> COMPLEi10N. <br />