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J �� z� -s <br /> __ r,- <br /> D2tp PUGLc WorMs Permil s <br /> Applicalion For em9.oeo�.• <br /> PUBLIC WORKS PERMIT Puhi¢WodsFee -- <br /> Total�ee S <br /> Less<oui.Fee Pa�O 5 <br /> Baiance oue S <br /> Print or Type Only . <br /> Plan Check No: B 45042 SEPA <br /> �w�P� Applicat.Date: 07/26/94 n Ph�nr. <br /> Job Addra: 1928 LOMBARD AVE <br /> Okner: HAWKINS RUSS <br /> Tenant: <br /> Proposed Uae: SFR/GARAGE ,p � phone <br /> Applicant Desc. of Work: <br /> NEW GARAGE <br /> Describe Proposed work _ OFFICE SET <br /> JOB SET <br /> APPRVD FOR PERMIT: DATE_/_�_ gy <br /> _ � <br /> Project Address 1�1 knownl .—_ .--.—_._----__ � <br /> Attach four(41 copies of plans for propo>ed wu�k � Drav: �o scai�z a:io nole tha 'dluv+ing as applicab�e: � <br /> • Properry Lines • Centerline nl strevt /^ <br /> • Outline and dimensions ol all existing and • InCicat; North �� <br /> proposed siructure5 on the lot • Sncw any r,roposeA gradiny chanaes <br /> • Existing and proposad utilities • Show measurements M <br /> W <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All calls for inspection shall be ma6e 24 hrs.in advance• phone 259•8810. ^ <br /> 2.All work shall be pedormed in accordance wilh this permit and current City ol Everett Design and Construction j <br /> Standards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800•424-5555. � <br /> � <br /> PUBLIC WORKS PEHMIT <br /> NO EQUIRE� � <br /> 8Y d <br /> ilATE � <br /> ,��� '1>,ee� /k tTn�e.�. � <br /> ����.�0 ��.�e�-._d . .s�s=,�.�. � <br /> f1tc.� �9�� ff"`�e.w u�6l�n.� <br /> � � b��a zd � ,��u...,�� ��L <br /> � �„U� } ,��' P�w..,��x p.�,Y,,,tf. <br /> �� C� _mY ACKNOWLEDGEME7VT OF CONOITIONS <br /> g 2 Cc����clN ------�- <br /> ihe�.indersiqned owner/apphc2n;hereby agrees to hold and save harm� <br /> � less ;he City o� Everett irom any and ali claims for damages cus�s. <br /> ; expenses or causes of action that may aris9 because ol insiallation <br /> - � -�- anA mainienance of �he improvement or other rigM-oFway use hereto <br /> Ia�N:e�; for and lurther a9rees lo remove same upon notice Irom Ihe <br /> Approved tor Construction Dale � C,ty ar� to rep�ace public property damaged thereby. <br /> i <br /> FINAL INSPECTION � Dale <br /> Approved as Construct�d Siqnature of Applicant Date <br /> WORK AUTHORIZED BY THIS PEAMIT MUST BE STARTED WITHIN <br /> PUBLICWORKSDEPARTMENT �80 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200CedarStreet 8E DILIGENTLY PURSUE� TO COMPLETION. THIS PERMIT MAY BE <br /> Everett,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> ..�_._.�e� oe�n .....� ir.rr nveo on neYC f111RATIf1N. <br />