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�l' �UB�IC APPlicalionFor 0 �1 POSTI <br /> WORKS PER NG <br /> P�a��� MIT --'— <br /> WORKS DEPqFl Date � <br /> 3200 Cedor Str�t�ENT 3'12-96 <br /> Everett,WA 98201 259-8810 <br /> Pubiic Wo�s Permit p C. <br /> n'PE OR Pq�NT ON�y �� <br /> Builtling Permit# <br /> SPezial 5�� <br /> owner Y Joe/Sandra 11529 3rd Pl W PublicWo�sF�$ — <br /> Mailinyqtldress Everett Wq <br /> �wner city 98204 290-12 <br /> '4PPIIcant ZiP 96 <br /> Mailing qdyress Phone <br /> Describe P�oposed Wa�k <br /> City <br /> new house ZiP <br /> Phone <br /> —� <br /> �— <br /> ►'ROJEC7 qppRESS(if kno � <br /> attacntour W�� 1E15 England Ave � <br /> (4)copies oiplans forprp�s� <br /> � �P`O�Y Lines �putline Wo`k-Draw to scalr and rA <br /> .. �Centedine and dimensions oi all e � note the follo r� <br /> o/st�l •Indicate '��stingand wingi�aPPlicabie: —� <br /> North 5how an FroPose�st°1clures on the bt ■ <br /> . Y Proposfty 9ratlin �istin � <br /> PERMIT 9changes •Show 9and��ti�g0lpp ppp�51 <br /> � A��C CONDITIONS: ��NOT VyR�TE ^1easurementsN�l � <br /> alls for inspectio BELOW THIS LINE � <br /> 2•All work shall be pertormed ne madaance u dvance-Phcn�259- �� 1112, � <br /> Const 24 h° rs in a <br /> ruction Standards and g accor with this <br /> 3• �a��Location Unde p��f�cations, pe��t 88��• ►� m � <br /> � rcJ�ound Service and curr�nt City of �•� <br /> � 48 hrs, before ��esi <br /> r ��'�/n,.?��.L�� � You dig. TOLL FREE NUM� � � O <br /> �// �'�/� �— ��1�3�'�55. <br /> �'-'' auo�9 us.on � <br /> �� sios,on � <br /> �' s�o.00 O <br /> � �3613.� a <br /> �5'i21.Bp <br /> �U <br /> APProved/or�o � � ( <br /> �t�0� �S thee undersign=d oW�el�W�EDGEMENT OF C <br /> Date � Cityo/Evei PPlicanth�ieb �NDI710NS <br /> INSP QN � -3 ' the S P�I meion tt fro manY andbl�laims lor d magesd and save harmless <br /> ECiI L m rove that Y arisa <br /> Mproved as ��orotherri ause o/installation costs,expenses,or <br /> Constructcy �o ��7 9h�'0�-Wayu,sehere�o antlmafnlenance <br /> Dale dam ged the me PO� ^otice fro aPPlicy/or of <br /> u <br /> reby. m the CitY antl to rePlace publ chP�operty <br /> WORK q�7�}�ORIZED � <br /> COMPLE7�aN BY THIS PERMIT <br /> 7F11S PERM171NqY BE CANCELLED iARTED WITMIN 180 D S�9nature <br /> BYT}�ECITYUPO AYSOFDA7EP Pli �`�_ <br /> NANYSTOPpqGEO MI7ISISSUED � <br /> WORK ON TH�g pq��E�R�`TER IS 70 BE DI�IGEN �ate ' <br /> OVER 90 Dqyg DU �Y P�RSUED TO <br /> RATION. <br />