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S C "7 <br />.0�1x <br />�H <br />Hfn <br />H�r <br />y <. r-i <br />K y� <br />"�rJ H'� <br />yx � t~g" <br />t7 O h'1 <br />H C7 <br />OH <br />�h8 <br />�� � <br />H <br />9 ~ <br />rNH <br />g�' <br />� <br />n�� <br />r <br />z y c�n <br />H O �i� <br />Date <br />qpplitation For <br />PUBLIC WJRKS P�RI��IT <br />TO POSTING a-i°�3 <br />Print or Type Only <br />Owner <br />Applicant <br />y. 3�0y51 seen <br />Plan Check No: C J613b �✓ <br />Applicat.Date: J3/26/92 <br />Job Address: 501 LAUREL DR <br />Owner: tiEWLANO� GEORGE <br />Tenar.t: <br />Proposed l!se: SItiGLE FAMILY RESIDENCE <br />Des^-. of 61ork: <br />ADDNji.r.N.ODEL - 271SF ADDN TO FAMILY RM <br />DINING RM� 1745F DECKOVEA UWHTF.11 STORAGE. <br />OFFZCE SET JOB SET <br />�escribe Proposed Work _ APPFOVED FOR PERMIT: �ATE__(_/_ BY <br />Project Atltlress (il known) <br />v�.:m�cwc�.nPa�.�,:. __ <br />9ie�. ooc� • <br />GuDLC WOtkf F!e 5 <br />TouiGee <br />lesa �oo� Fee Pam 5 <br />BLance Due 5 <br />� Phone <br />� Phone <br />Attach lour ;a) copies oi plans br proposed work- Dr,�,, to rcale and note th^. iollowing as applicaCte: <br />• Property Lines • Centerline of �Ireet <br />• Outline and dimensions '' eu existing and • Intlicate North <br />prOposed structurP: on lhz �et • Show any proposed gfading chanoes <br />• Existing and Nroposed uti!ities • Show meosuremen�s <br />on <br />TH <br />PERMITCONDIT��ivS <br />t. All calls fr,- irspeclion shall be made 24 hrs. in advance- phone 259•tl810. <br />2. All �orN shall be peAormed i� accordance with thi, peimit �r�d current Ciry of Everetl Qesign and Construcf�:�: <br />5tandards and Specifications. <br />3. Call Location Underground Servicn d7� hrs. bewre you dig. TOLL FREE NUMBER 1•800•4-'�i-5555. ' <br />(�� � i:-� ��:n-� ��,-,� r� 1��� �- ��� ��. <br />�;/�2//92 - � I � j � " <br />� 1 ' <br />/%.GL7/�t�� / . <br />/�a acl��t� <br />,%_ k � `,�-�- <br />P� J �_ 92 J <br />��1U�Z �-J L. � /������ /� <br />i�G� 3 1 73� D%�7 �/,N��i.l <br />Approvetl lor Gonsiruclion Date <br />FINAL INSPEGTION <br />Approvetl as Constructed <br />�e� PUBIIC WnNKS DEPARTMENT <br />y 92C0 Cedar Streel <br />i � <br />.�.� EvcretL W� 90�01 <br />Prtor.e: 759-0810 <br />Date <br />Z <br />O <br />ACKNOWLEDGEh1GNT OF CONDITIONS <br />The undersigned owner/applicant hereGy agrees to hold and sa�� harm� <br />less the Ciry of Everett Irom any and all claims tor damages costs. <br />ezpenses, or causes ol action Ihat may arise because of installation <br />and maintenance ol ihe improvement or o�her righ4ol�way use hereto <br />applietl for and �urther agrees to remove same upon notice irom Ihe <br />C�ry and to replace OuDlic p�operry damaged Ihereby. <br />SignaWrc ol Pppliwnl Date <br />WORK AUTH�RIZED BY THIS PERMIT tdUST PC- STARTED�WITHIN <br />180 DAYS OF OATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLV PURSUED TO COMPLETIO�l. THIS PERM1t1T MAY BE <br />G��NCELI.ED 6Y THE GTY UPOY ANY SiOPPAGE OF WOFK ON TNIS <br />PFOJEGT OVER 90 DAVS DURnilO�� <br />