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�r� <br />[>if <br />,0�1x <br />Q f-+ <br />9�H� <br />� � 7.f <br />� Ul H <br />[�] O � <br />OH��y <br />H�1 L'�� O <br />y� V � <br />9 H� <br />gHy <br />N <br />H <br />cp� C7 � <br />t4 � t�l <br />Z H ln <br />HO� <br />4;. <br />'f•,. <br />Date 9/10/91 <br />4., <br />�%: .., <br />> ' �� `s . <br />� =�i. <br />Application For <br />PUBLIC WORKS PERMIT <br />Prin! or Type Only <br />\n, PuoLCYrorxsPerm��t+ <br />�A���� 91/27671 <br />\� aiao o�.p�.. <br />Puei¢worxsFoo S <br />Total Feo <br />Less FoO� Fee Paid � <br />Oatanc¢ �ue S <br />Lackey, Cha�les 6504 Lombard Lverett 98203 pnone <br />Owner Mailing Address Ciry Zip <br />North Sound Builders 14404 Smokey Pt Blvd Marysville 98270 653-2512 <br />Mailing Address City Zip Phone <br />Applitant <br />Describe Proposetl work Bedroom / bath addn — 36CSF <br />project Addre�s (il known) <br />6504 Lombard <br />Attach tour (4) copies ol Plans for proposed work - Cmw to scale and note the �ollowinc� as app�icable: <br />• Properry Lines • Centerline ot slreet <br />• Outline and dimensions ot all eaistinp and • Intlicate North <br />proposed slructures on the lot • Show any pruposed grading r,hanges <br />• Exisling and proaosed utilities • Show measurements <br />PERMIT CONDITIONS <br />i, All calls for inspection shall be made 24 hrs. in advance - Phone 259•8(310. <br />2. All work sha!I be pedormed in accordance with this permit and current Ciry of Everett Design and Consimction <br />Standards and Specilicat�ons. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE MUMBER 1-800•424-5555. <br />��aEcc G�Jo,iy.i jv-v�°,f m,ol`� �P�-vv��. <br />�Ya 9-�i-9/ <br />.T. _ <br />� -' - - ,� ��,�.. <br />f�o.r�,��y n.Qe�' -to c/fic�., ,�O ser -�� <br />-- .� Jr�za.�' .L�7` 6�.cic' /L�. i: w.t.+ . /fl = S •• .��-r-.r�.i <br />p � d•-�. �{.4� µPa.,w- -»,a,�. � ,&e eovl�ef de�T°�L, ,t ,�o.�J- <br />IY. g� <br />Approved for Construction Dale <br />FINAL INSPECTION Date <br />ppproved as Constructed <br />PUBLIC WORKS DEPAFTMENT <br />3200 Cedar Street <br />Everetl, WA 90201 <br />Phone:259�8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned cwnedapplicant hereby agrees to hcltl and save harm- <br />less lhe Ciry ot Everett irom any and all claims for tlamages, costs, <br />ezpenses, or causes of action thal may arise because of installation <br />and maintenance ol the impwvement or other ric�h4ol�way use hereto <br />applied tor and turther agrees to remove same upon notica irom the <br />City and to �eplace public property damaged ihereby. <br />Si9nawre ol Applicant Date <br />WORK AU�HORIZED BY THIS P[R'v11T MUST BE STARTED WITHIN <br />180 DAYS O� DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PFRMI: �.'AY BE <br />CANCELLE� BY THE CITY UPON ANV STOPPAGE OF WPRK ON THIS <br />FROJECT OVER 90 DAYS DURATION. <br />�� <br />