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Date � PuOi¢WorFa Permit r <br /> Applicalion ror e�aa oeo�.• <br /> y�H PUBLlw WORKS PERMIT P�oocWorwsFee <br /> x r^� To�al Fee s <br /> �'9 y Lafa Aopl Fee PaiE 5 <br /> ��H <br /> Print or Type Oniy e.m��,o�� s <br /> >H tn <br /> H x� <br /> �C C] Plan Check No: B 39799 SEPA <br /> O x O � Applicat.Date: 03/OS/93 <br /> � H„� Owner Job Address: 5112 DELAWARE Zip Phor.e � <br /> �H Owner: JONES DOt7 <br /> Tenant: <br /> y Z r Proposed Use: SINGLE FAMILY RESIDENCE <br /> O yd Applicant DNEW�ATTACHED�GARAGE Z�P Phone <br /> • <br /> H �� Describe Proposed l:crk _ OFFICE SET JOB SET <br /> (�]Y n <br /> H <br /> a y _ APPROVED FOR PERMZT: DP.fE_/_/_ BY <br /> r z - <br /> r-�H <br /> � yH W� d� <br /> � �r Prolecl Address(i � �) L <br /> � Attach lour 4 co lans lor ro osed work• Draw to sca�e and note Ihe lollowin as a licable: r <br /> HOU1 O 4 P P P 9 PP' � <br /> • Propen es • Centerline ol street � <br /> • Oulline , dimensions ol all eaisting antl • Indicate North <br /> proposetl ��tures on Ihe lot • Show any proposed grading changes <br /> • Ezisting acc �. ;pcsed utilities • Show measurements � <br /> DO NOT SNRITE BELOW THIS LINE <br /> PERMITCONDITIONS O <br /> �..� 1.All call;tor inspection shall be made 24 hrs.in advance•phone 259•8$10. � <br /> �� 2.All work shall be periorned in accordance with�his permit and eurrent City ol Everelt Design and Conslruction . <br /> Standards ard Speciticalions. <br /> 3.Call Location Underground Service 4B hrs.belore you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> �� <br /> � ' O <br /> '1_ <br /> � � <br /> PUDLIC WORKS PERMIT <br /> NOT AEOUIRED � <br /> ��'� B Y � l <br /> DA7E ' ''� O <br /> / <br /> 1!j li <br /> I�' � ACF�NOWLEDGEh1ENTOFCONDITIONS <br /> The undersignetl owner/applicant nereby agrces to hold and save harm- <br /> less the Ciry ol Everet� Irom any and all claims lor damages, cosls, <br /> ezpenses, or causes ol action Ihal may ariso because of inslallation <br /> j and maintenance ot the improvement or olher righl�ohway use hereto <br /> applicd lor and lunher agrecs to remove same upon notice Irom ihe <br /> Approved lor Construction Date City and to replace public property damaged thereby. <br /> =1NAL INSPECTION Date <br /> 4pproved as Conslructed Signalure ol Applicant Date <br /> PUBLICWOF7KSDEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> i—_ 780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER �S TO <br /> /F" � 3200CedarStrecl <br /> ���� Everett,WA�8201 BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Phone:259�6810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br /> -- _ . � <br />