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i <br /> CApplkatbn For �ai@ <br /> PUBLIC WORKS PERMIT <br /> PUBLIC WGRKS DEPARTMENT Public Works Permit k <br /> 3200 Cedar Streei <br /> Everett, WA 98207 (425) 257-8810 Building Permit# <br /> TYPE OR PRINT ONLY Public Works Foe$ <br /> Owner Plan Check No.: 89909-001 Phone <br /> Job Address: 2032 LOMBARD AVE <br /> Appficant Owner: DAMERY PHILLIP Phone <br /> Tenant: <br /> Appliption Date: 9/1/99 � <br /> Desc�;:;e Proposed Work_ Proposed Use: SFR <br /> TyFe of work: CHANGE OF ROOF TO HIP � <br /> Office Set— ]ob Ser Fre/Planning Set � <br /> Approved For Permil Date: By: ♦/� <br /> ♦/� <br /> PROJECTADDRESS (if known) m <br /> Attach four(4)c�pies pians for proposed work•Draw to scale and note the following If applicable: O <br /> •Propsrty IJnes •Outline and dimenstons of all existing and proposed structures on the lot •Existing and proposed utililies � <br /> •CenteAine of street •Indicata NOM •Show any proposed grading changes •Show measurements <br /> DO NOT WRITE BELOW THIS LINE Z <br /> PERMIT CONDITIONS: O <br /> 1. AII calls for inspection shall be made 24 hours in advance - phone (425) 257-8810 <br /> 2. All work shall be performed in accordance with this permit and current City o( Everett Design and ■ <br /> Construction Standards and Specifications. r <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. //\ <br /> ♦/♦ <br /> O <br /> � <br /> :"UDLIC N✓pqKS PERMi � <br /> IVOT EOJIREA <br /> tY_____-,�7��.. <br /> RATE�_-IL� --` <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned ownedapplicanl hereby aprees to hold and seve hamiless <br /> the City of Everett Irom any and all clalms for damagas,costs,expenses,or <br /> pprove or ons ruc ion ate causes ol action that may arise because of insfallation and meintenance of the <br /> Improvement or other right-of-way use hereto applied for and further agrees to <br /> remove same upon notice from tha Ciry and to replace public property dam- <br /> aged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed <br /> gna ure o pp iran a e <br /> } <br /> WORKAUhiOR�D BY hIIS PERMR MUST BE STAHTED WfT}iIN 1B0 DAYS OF DATE PERMR IS ISSUED AND hEREAFfER IS 70 BE DILKiENTLY PURSUEO TO <br /> COMPLETION.THIS PERMR MAY BE CANCELLEp gY THE CfTY UPON M1Y S1UpFqCaE OF N�OFifC ON TIiIS PRG.ECTOVER 90 DAYS DURATION, <br />