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Date � a�cr�wo,k,aa,mn, <br /> Application For eioo.Dem.+— <br /> PUBLIC WORKS PERMIT P°°°°W°�°,F°° <br /> Tolal Fee $ <br /> Lesf AOGL Fee PaiE S <br /> Print or Type Onl�i Plan Check No: c 44262 sEPA e,�.��so�a s <br /> Applicat.Date: OS/03/94 <br /> Job Addra: 7205 JbNIPER DR <br /> Owner: PARKINS PAT <br /> Tenant: <br /> — Propoeed Use: SINGLE FAMILY RESZDENCE <br /> Owner Deec. of Work: Zip Phone <br /> ADDITION <br /> Agplicant OFFICE SET _JOS SET ZiP Phone <br /> APPRVD FOR PERMIT: DATE_/_/_ BY <br /> Describe Proposed Work <br /> _ W <br /> Project Address(if known) � <br /> AUach four(4) copies of plan, for proposed work• D�aw lo sCaie and notr. the lollowing as applicable: s <br /> • Properly Lines • Centerline of street � <br /> • Outline and dimensions of all exisling and • Intlicate Norih <br /> proposed structures on Ihe lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measuremenls M <br /> W <br /> DO NO'Y WFITE BELOW THIS LINE O <br /> PERMIT CONDI710NS � <br /> 1.All calls lor inspection shall be made 24 hrs.in advance-phone 259•8810. � <br /> 2.All work�hall be pedormed in accordance with this permit and current Ciry of Eve�rett Design and Constructior. <br /> Standards and Speclficalions. <br /> 3.Call Location Underground Service 48 hrs.be(ore you dig.TOLL FREE NUNBER 1•800•424•5555. � <br /> 0 <br /> ' �.18LIC WOHKS PERMIT � <br /> WOT AEQUIaED //� <br /> �tY . 8 , N♦ <br /> �ATE '� � �?� O <br /> � <br /> ACK�VOWLEDGEMEtJT OF CONDITIONS <br /> The undercigned owner/apPlicanl hereby agrees lo hold and save harm- <br /> less Ihe City ol Everell irom any and all claims for damages. costs, <br /> expenses, or causes of attion iha� may arise 6ecause of installation <br /> and mainlenance ot the improvemenl or olher right-of•way use hereto <br /> applied lor and lurther agrees lo remove same upon notice from Ihe <br /> Approved lor Constru:tion �a�e City and to replace public property damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed S�gnature ol P.pplicant Date <br /> PUBLIC Wi�RKS DEPARiMENT `�'�GRK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 180 DAYS OF DATE PERMIT IS ISSUED AtJD THEREAFTER IS TO <br /> 3200CedarSireet BE DIL!G[NTLI' PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Everett,WA 98201 CA�!CELLED 8Y THc CITV'11PON ANY STOPPAGE Of l4'ORK ON TI IIS <br /> Phone:259�3810 I PROJECT OVER 30 DAYS DURATION. � <br /> I <br /> � <br />