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��� <br />m�x <br />C H <br />>H� <br />r <br />y H <br />k n <br />H � <br />'�s] H "i1 <br />(/� FI <br />�O� <br />H C7 <br />OH <br />xl C] q <br />H[�JO <br />�� nq <br />9Ht+1 <br />� <br />r HH <br />t7 U+ <br />O H <br />C'] C7 V� <br />�e�r <br />r� <br />z�cn <br />yOrn <br />6� s <br />v �1 <br />w � <br />� ` <br />� <br />"`�1s <br />Date <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Onty <br />Owner <br />Applicant <br />Describe Proposed Work <br />Plan Check [70: C 36138 SEPA <br />Applicat.Date: 03/26/52 <br />Job Addreas: 2806 LEONDARD DFt <br />Owner: SEWELL CHRTS <br />Tenant: <br />Proposed Use: SINGLE FAMILY RESIDENCE <br />Desc. of Work: <br />REMODEL / ADDITZON <br />OFFICE SET JOB SET <br />APPROVED FOR PERMIT: DATE_/_/_ BY <br />i <br />Peayc elo.: N.•m:. <br />� omq. oeo�. • — <br />Puobc Worhs Fefi S <br />TotelFee <br />LeesnootFeaPaie S <br />!lnlance Cuc $ <br />Proiect Adtlress �if known) <br />Attach tour (4) copies ol plans for proposed work - Draw lo scale antl note Ihe following as applicable: <br />• Pwperty Lines • Centerline of street <br />• Outline and dimensions of all ezisting antl • Inaicate North <br />proposed siructures on Ihe lot • Show any proposed grading chan9e; <br />• Existing antl proposed utilities • Show measurements <br />none <br />Phone <br />PERMITCONDITIONS <br />1. All calls lor inspection shall be made 24 hrs. in advance- phone 259•8810. <br />2. All work shall be performed in accortlance with this permit and cwrent City of Everett Design and Construction <br />Standards and Specilications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•8U0•424•5555. ' <br />�� � <br />/�.� n�. <br />Approvetl lor Consiruction <br />. . i. .� t.,_� : , � .. � , . , . <br />, <br />, �; : �� ��, - ,. <br />��� y � ' �a _. , (- l�� l/tn - f.e <br />�,- y <br />� � <br />.`.0 l � ' <br />�, �� I��� , , ., � ✓ <br />U� �;�` <br />,���,,, ti(� <br />�� <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersignetl ownerlapplicant hereby agrees to hold and save harm� <br />less the City of Everetl from any and all claims lor damages, costs. <br />ezpenses, or causes of action that may anse because ol inst211ation <br />and maintenance of the improvement or other righ4ol-way use hereio <br />app6etl for and lurther agrees Io remove same upon notice Irom the <br />��� City and to replace puhlic property damaged ihereby. <br />FINAL INSPECTION Date <br />Appmved as ConSirucied <br />�`�PUBLIC WORKS DEPARTMENT <br />J20o Ceaar Street <br />T Gvereli, WA 99201 <br />Phone: 259�8810 <br />Signature ol AppIiC�N uaie <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED�W�THIN <br />180 DAYS OF DATE PERMITISISSUED AND THEREFFTEfl IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PER1.11T MAY BE <br />CANCELLED BV THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DnYS DUPATION. <br />, , � � , � .. ' , i� <br />