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Date ��� �~ a�oucwo�.avo,mn. <br /> ��C9 Deat• <br /> Application For <br /> PUBLIC WQRKS PERMIT '°°'"'"°'"„" <br /> y�� . Talal Fee S � <br /> '�Yj� Lev Aocl Fee PaiC g <br /> >H o,i���o o�� 5 � <br /> C�rx-+ Print or Type Only <br /> t9" xy� <br /> H Z r�-+ <br /> K y� Plan Check No: B 38975 SEPA Zip Phnne <br /> Owner Applicat.Date: 12/11/92 <br /> .�r� H'��J Job Addrese: 1619 EDGEMOOR LANE ' <br /> y H Owner: SOVEY PAUL 6 .70�CE <br /> yx x C Tenant: <br /> [�] y� .� plicant Proposed Use: SINGLE FAMILY RESIDENCE Zip phone <br /> � Desc. of Work: <br /> O H ADDITION <br /> � �� Descrihe Proposed Work . <br /> 4]� C] OFFICE SET JOB SET <br /> Z y '��y APPROVED FOR PERMIT: DATE_/_/_ gY <br /> �' H y L�� <br /> � <br /> H <br /> c� C ti H <br /> Prolect Address(il known) <br /> � �y Atlach lour(4)copics o!plans for proposed work� D�aw to scale and note the�ollowing as applica6le: � <br /> y O!n • Property Lines • Cenlerline ol street ♦^ <br /> • Oulline and dimensions oi all ezisting and • Indicate North V� <br /> proposed str�ctures on ihe lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurementa M <br /> W <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> '�, � 1.All calls for inspection shall be made 24 hrs,in advance-phone 259•881 O. �\ <br /> ' 2.All work shall be pedormed in accordance with this permil and currenl City ol Everetl Design and Conslruction ♦ <br /> '�'� Standards and Specilicationa � <br /> 3.Call location Underground Service 48 hrs.belore you dig.TOLL FREE NUMBER 1•800•424-5555. � <br /> '� O <br /> �1� ~ <br /> �� PU9LIC WOHKS PERMtT ♦^ <br /> NOT REOUIRED� Y/ <br /> I�.i...� ev �5 O <br /> � DATE.....L� �S � � � <br /> � � � <br /> „. ri <br /> �CKNOWLEDGEM1t[NT OF CONOITION5 _ <br /> �� The undersigned owneUapplicaN hereby agrees to hold and save harm� <br /> less Iho City ot Everelt Iwm any antl al� claims tor damac�es, costs, <br /> e:penses, ur causes nl ection Ihat may arise because ot inslallation <br /> and maintenance ol the improvemenl or olher right-obway use hereto <br /> �� applied lor and further a9recs to remove same upon notice Irom ihe <br /> �pproved lor Construction Date City and lo replace public propeny damaged ihereby. <br /> INAL INSPECTION Datc Oale <br /> �ppwved as Conslructed Signelure ol Applicant <br /> ��ayE� PUBLICWORKSOEPARTMENT WOAK AUTHORIZED BY THIS PERM1IIT MUST BE STAPTED WITHIN <br /> 78U DAYS OF DATE PERMIT IS ISSUED AND THEHEAFTER IS TO <br /> 3200Ced�rSlrcet B[ DILIGENTLY PURSUED 7p CO��PLETION.THIS PERMIT MAY BE <br /> b� Everell,WA98201 rANCELIED BY THE CIT\'UPON AIaY STOPP�GE OF',VORK ON THIS <br /> Phonc:259��870 PROJECi OVER 90 D�YS DUf7A'ION. <br />