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��� <br />�y <br />9HN <br />r <br />y H <br />fC C] <br />H 7d <br />"�� H � <br />fA H <br />[l1 0 � <br />ON <br />��,g <br />4]r (] <br />zH� <br />�HH <br />y <br />gCd� <br />�[�7 <br />HV�i <br />HO�n <br />G` <br />Date -(' ��� <br />Applicatlon For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />r <br />flalic Wo�kf Permll • <br />B�CG.OePL• �O��i�'(Z— <br />Pupl¢WodaFee s <br />tm�i Fae <br />Leff AOG� Fee P�iO S <br />B�I�nceCue S <br />Plan Check No: B 36262 SEPA <br />Applicat.Date: 04/OB/92 <br />Job Addrs: 927 GRAND AVE — <br />OW� Owner: GALT JOHtJ Zip Phone <br />Tenant: <br />Propoaed Use: SZNGLE F:v1ILY FE',IDENCE <br />�ese. of Work: <br />PARTIAL PATIO COVER (AL50 F�NCE AND ARBOR) Z�p Phone <br />APP <br />Describe <br />� <br />OFFICE SET JOB SET <br />APPRVD FOR PERMIT: DATE_/_/_ BY <br />Prolect Address �if known) <br />Attach lour (4) Copies ol plans lar prOposed work - �raw lo Scale and note the Iailowing as appliCable: <br />• Property Lines • Centerline ol streel <br />• Outline and dimensions ol all existing and • Indicate North <br />prODoSed slrUctures on the lot • Show any propo5ed graCing Chanqes <br />• Existing and pro0osed ulilities • Show mexsurements <br />PERMIT CONDITIONS <br />t. Atl calls lor Inspection shall be made 24 hrs. In advance • phone 259•8810. <br />2. All work shall be pertormed in accordance with this permil and current City ol Everetl Design and Constructlon <br />Standards and Specificatlons <br />3. Call Location Underground Sarvice 49 hrs. before you dig. TOLL FREE NUMBER 1•800-424•5555. <br />�'�G'���:_e� c-_z>:/-_ f�s,�.•,., (� •` �,��,�<<tcc _:�/ <br />( <br />r .'� <br />�� _ <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />ppprov,C as Constructed <br />�PUBLICWORKSDEPARTMENT <br />3200 Cetlar Street <br />Eeeretl ��A 98201 <br />Phor.e: 259�8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City ol EverMl Irom any and all claims lor damages, cosls. <br />expenses, or causes of action that may arise because ol inslaliation <br />and maintenance ol Ihe improvement or other right•ol•way use hereta <br />applied for and �uriher agrees to remove same upon nolice Irom the <br />Cily and to replace public property damaged ihereby. <br />Signalure ol APP�icant Date <br />WOFK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TU COMPLETION. THIS PERMIT A1AY BE <br />CANCELLED BY THE CIN UPON ANY STOPPAGE OF NORK ON THIS <br />PROJECT OVER 90 DAVS DURATION. � <br />