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DeIB � � o�e�Kwon.vr�ma. <br /> eiao o.o�. 3(/�}7/ <br /> Applicatlon For <br /> PUBLIC WORKS PERMIT P°°e;;�::`� : <br /> �n..ca.»r.n s <br /> e�u.c.o.. f <br /> Print or Type Only <br /> Owner Plen Cheek No: B 3fi571 SEPA �ip P�one <br /> AppllceC.Data: OS/O1/92 . <br /> .7ob Addre: 1625 ENCLAND AVE <br /> Ownert HILLAN TOM <br /> TCnents <br /> ApP�iwnt Pcopoeed Use� SINGLE FAMILY R65IDENCE i0 P�one <br /> Desc. of Works <br /> 13055F ADON <br /> OeecrlEe ProOosetl Work _ <br /> OFFICE SET JOB SET <br /> APPAVU FOR PERMIT: DATE_/_/_ BY <br /> W <br /> Proiecl AEOress�il known) H <br /> Allat�lou�(4)to0ies ol plan9lor pro0osed work-Dfaw l0 5tale and note��e 1011owing as ap0liCaCle: � <br /> � •Propeny Unes •Centedine ol siree� /A <br /> •Outlina en0 dimansions ol ell eaisling antl •Indicale Norih V� <br /> proposetl alruclurea on t�e lo� •S�ow any proposeA qraOing chenpes <br /> • Evisling entl proposed utililies •S�ow measuremenls /M <br /> W <br /> DO NOT WRITE BELOW TMIS LINE O <br /> PERMITCONOI710NS <br /> 1,All celle ror Inapedlon anall De�neae z4 hrs in anvence•phone 259�8810. ^ <br /> 2.All work shall6e peAormetl In eccordance wit�t�i:permlt en0 cunent City ol Everalt Desipn end Consiruclion � <br /> Standerds an0 Speclfications <br /> 3.CaIILaatlonUnderqrountl5ervica4B��abetorayoudig.TOLLFPEENUMBENI•800�424•5555. � <br /> �i <br /> ub�.c u�c�n��oii-,,,��( /Uof,<'rpa�u� <br /> �� � F. <br /> ��--;� V� <br /> , O <br /> _ � ; . : - a <br /> ;�, �'� .:�,�-�,� ,F, ..�,.r � '� ,�p,r9�b�qo <br /> "GtJ C..� CC."r atf c�<<`. FG.%m�� i . '-_J Y a <br /> `r,rA � �^.� ii/f,�` C.:� { .��r,-ya�s � � ACKNOWLEDGEMENTOFCONDITIONS <br /> � Theundeniqnedowner/appllcant�erebya9reeato�ol�antlsave�erm• <br /> less t�e Cily ol Everel� Iront any anE all claims lor tlameBo; cosiS <br /> e.penses,or causes ol acliou t�at may arisa Decause ot installation <br /> and maintenente ot lha imp�ovement or other�iq�l�ol�way uso hereto <br /> applieE lor antl lurt�er agfaBS lo remove seme upon nOlite Ifom t�e <br /> Aonruvod lor Construcllon Oate City and tu replaca public pro0erty EemaBPd Ihereby. <br /> FINAI INSPECTION Dale <br /> ApprOvOE 85 COn5lfut�Bd Slqnelur0 OI AOVlitenl Da1e <br /> � PUBLIC WORI'SDEPARTMENT �VORK AUTHORIZED BY THIS PEHMIT MUST BE STARTED 1VITMIN <br /> 3200CoCerStr:e� 1B0 DAYS OF DAT'e PEHMIT :5 ISSUED ANO THEREAFTER IS TO <br /> Everatl WA88201 BE DILIGENTLY PURSUED TO COMPIETION.TMIS PERMIT MAV BE <br /> P�one:P59�BB10 CANCELLED BY THE CITY UPON ANV STOPPAGE OF WORN ON TMIS <br /> PNOJECT OVER 90 DAYS OURATION. <br />