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��� <br />� <br />b � <br />G M <br />7 H y <br />H � 'l. <br />��� <br />O � O <br />� fA M <br />� H � <br />O H <br />tic�a°c <br />n• n <br />N <br />t� y <br />H H <br />17 N <br />O M <br />no�n <br />� � M <br />x H N <br />H O N <br />Date <br />Applir,ation For <br />Pl16LIG WORKS PER11�1lT <br />Print or Type Only <br />Plan Check No: H 35064 SEPA <br />Applicat.Date: 12/12/91 <br />Owner Job Address: 3615 LOMBARD <br />Own�r: NELSON JAMES C <br />Tenant: <br />Proposed Use: SINGLE FAMILY RESIDENCE <br />Applicant Desc. of Work: <br />ENCLOSE PORCH AND ADD BATHAOOM <br />Describe Proposed Work OFFICE SEi� JOB SET <br />APPROVED FOR PERMIT: DATE_/_/_ BY <br />Prolect Address (il known) <br />Publlc Ylorka Pe�mit s <br />B�ae oeVl. + � <br />PublicWo�ks�cc 5 <br />Tatal f ee <br />LessADCL Fee Paid S <br />Balance Due $ <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the lollowinp as applicable: <br />• Property Lines • Cenlerline ol street <br />• Outline and dimensions of all existing and • Indiwte North <br />proposed structures on ihe lot • Show any proposed grading changes <br />e Existing and proposed ulilities • Show measurements <br />UNE <br />?hone <br />Phone <br />PERMIT CONDITIONS <br />1. All calls �or inspection shall be made 24 hrs. in advance- phone 258�0$i0. <br />2. All work shall be pedormed in accordance with this permit and current City ol Everett Design and Consiruction <br />Standards and Specilications. <br />3. Call Location Underground Service 48 hrs. betore you dig. TOLL FREE NUMBER 1•800•424-5555. <br />./ �r <br />� <br />/ L �'� . �' > ( ��.� ^ �'�u't"�-e,, <br />« <br />C1%,L , �.�1/I�--<- <br />Approved for Construdion Date <br />,, <br />��� <br />�: <br />i: � ,�_ _, � <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City of EvzreH from any and all claims for damages, costs, <br />eapenses, or causes of action that may arise because ol installation <br />and maintenance ol the improvement or other righ4ol-way use hereto <br />applied for and lurthzr agrees to remove same upon notice Irom the <br />City and ro replace public property damaged thereby. <br />FINAL INSPECTION Date Date <br />Approved as Constructed SignaWre of Applicant <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />PUBLICWORKSDEPARTMENT 1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />3200CedarStmr.1 BE DILIG[NTLY PURSUED 70 COMPLETION. THIS PERMIT MAY BE <br />�' Everett, V4A 98201 CANCELLED BY THE GTY UPON AN}' STOPPAGE OF WORK ON THIS J <br />Phone'. 259-F3B10 PROJECT OVER �0 DAYS DUPATION. <br />