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� C � <br /> Cn <br /> 9H <br /> C> � H <br /> 'r8� �--i Date /!r 9-1 .oi��wo..,ae.mn�S�— <br /> Bicq.Dao�• <br /> O x O APPlicatlon For <br /> yNC PUBLIC WORKS PERIIAIT P�oi�cworxsFea <br /> ToialF<e 5 <br /> !{! O � �lSSPO��FB<Pdb � <br /> G 5 <br /> y d eaanceoue <br /> O �""� print or Type Only <br /> �. �g <br /> H C: <br /> �` n Plan Check iio: B 35998 SEPA <br /> z H G3 Applicat.Date: 03/16/92 <br /> > y z JoL Address: 1414 KOSSUTH AVE phune <br /> ' Owner Owner: O'NEIL, PAT <br /> r H y Tenant: <br /> � � Proposed Uee: SINGLE FAMILY AESIDENCE <br /> ~ De6C. of {POrk: <br /> n C'� DECR/CARPORT ADDN 416 SF Phone <br /> � � � qpplicant <br /> z y �`' OFFICE SET JOH SET <br /> y �� �escribo Proposed Work _ — <br /> APPROVED FOR PERMIT: DATE_/_/_ BY <br /> W <br /> Proiecl Address(il knowr) � <br /> � <br /> Attach lour(4)copies of plans lor proposed work- Draw to scale cnd note the lollowing as applicahl=: � <br /> • Property Lines • Centerline ol siree� <br /> • Outline an0 dimensions of all existing and • Indicate North <br /> proposed stmctures on the lot • Show any proposeC grading changes <br /> s Existing and proposed Wilities • Show measuremerts M <br /> w <br /> DO NOT INFITE BELOW TIiIS LINE � <br /> ' ' PERMIT CONDITIONS � <br /> ' ' 1,All calls for inspection shall be made 24 hrs.in ativance-phone 259•881 O. <br /> � 2.All work sha!I be pedormed in accordance with this permit and current City of Ecerep Design and Conslruction <br /> Standards and Sp?cilica;ions. � <br /> '�' 3.Call Location Und�arground Ser�ice a8 hrs.betore you tlig.TOLL FREE NUMBER 1•800•424•5555. . <br /> �_I O <br /> I - � , � <br /> /� �[� ��C��J.C, .t. Cr�' .f _ - �.� . .. . f ' , - :/ <br /> Y . : <br /> -' /': . <br /> i Y/ <br /> �I A <br /> l.- � <br /> e- <br /> _ d <br /> ►-1 <br /> �' ACKNOWLEDGEMFNT OF CONDITIONS <br /> t ' The unCer,igned owner/applicant hereby agrees to hold and save harm- <br /> ' less Ihe Ciry ol Everatt from any and all claims for tlamages. costs. <br /> � expenses, of cause5 of 2Cti0n Ihat may arise bewu5e of installation <br /> and maintenance of the improvement or other righl-of�way use hereto <br /> - applied for antl further ag�ees to remove samr, upon notice from Ihe <br /> Approved lor Construction Date Cily and lo rep�ace public properry damaged thereby. <br /> =1NA!INSPECTION ��1e Datc <br /> pprove.f as Construcfetl <br /> Signature ol APPlicant ' <br /> � WOqI< AUTHORIZEU 8Y THIS PERMIT MUST BE STARTED�N'I <br /> PUBLICWDRKSDEPAR7MENT 180 DAVS OF DATE PERMIT IS ISSUED AND 'fHEREAFTER I� iU <br /> 32J0 Cetlar Streel BE DIUGENTLY PURSUED TO COMPLETION.THIS PERA1iT �1AY BE <br /> ,F Everett,WA 90201 CANCELLED BY THE CITY UPON AN�STOPPAGE OF WORI<ON THIS <br /> Phone:255�8610 PROJEC�OVER 90 DAYS DURATION. <br />