Laserfiche WebLink
Date <br /> Pu01w WerR�p�rmX• <br /> Application For 1 I aieo.oeq.•��7.3� <br /> PUBLIC WORKS PERMIT ���KW��F� <br /> Tol�l FN s <br /> L�o�opl FN P�iO s <br /> Print or Type Only e.�.M.o�. s <br /> Owner Plan Check No: C 38731 SEPI► Phone <br /> Applicat.Dat�: 11/17 92 . <br /> Job Addr�: 2113 C l�yg <br /> Ownert DONALDSON L1�YTpN <br /> Applicant T�nant: <br /> Propo��d U�a: SINGLE FAtiILY R85IDBNCE Phone <br /> D�tc, of Mork: <br /> INTSRIOR RENODBL <br /> � Describs P�opoaed Work <br /> OFFIG'8 S8T JOB S8T <br /> � 11PPRVD FOR PERMITt DATE_/_�_ gy <br /> W <br /> , Project Addnes(il known) � <br /> Attach four(4)copies o1 plans for proposed work• Drew to scale and note the followinp as applicable: � <br /> • Proparty Unes � � Centerline ol atreet � <br /> •Outlin��nd dimenslons of�II existinp�nd • Indicate North <br /> proposed struetures on the lot • Show any proposed predinq ch�nqea <br /> �� • EKistinq and proposed utllitiea • Sbow measurements � <br /> DO N T WRITE BELOW THIS LINE <br /> PERM�T CONDITION9 O <br /> 1.All utls for Imqctlon abdl be m�de 24 ha In adv�nce•phone 259-881 O. � <br /> 2•AI�work M���bs psAamed in accordance with thls permit and curront Ciy ot Everott Denipn�nd Constructlon <br /> Sbndard��nd SpecH�atione. <br /> 3.GII Loutlon Undsrpround 3ervlce 48 hra beforo you dp.TOLL FREE NUMlER 1-800�424bb6b. � <br /> � O <br /> PUB��C {yORKS p � <br /> NOT qEOUIREORM�T <br /> , BY � � <br /> DA7E ,/ � 92 O <br /> i <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/�ppllcant hereby aprees to hold end uve horm- <br /> lees the City ol Everett irom eny and all cl�ima lor damape0. coat0. <br /> ezpensea, or ceusen ol action that mey ariae bscause oi inetelletlon <br /> �� and meintenance ol the imprrnement or other tlghPohwey uee heroto <br /> � applied for and further eqreet to romove ume upon ootice from the <br /> �ApproveA lor Conatructlon Date City and to replace public property d�maged thereby. <br /> FINAL INSPECTION Date <br /> ApproveC as Conslructed Signature ol Applicant Date <br /> � PUBIIC WORKS DEPARTMEN7 WORK AUTHOFIZED BY THIS PERMIT MUST BE STARTEO WITHIN <br /> 3200CedarStreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS �TO <br /> Everott WA 98207 BE DILIGENTLY PU(i5UE0 TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:259•88t0 CANCEILED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />