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Date 5-18-95 � � � J '� �,��,����,�,��r•�,m,�. ---- <br /> oinn o„r.i • — 4a374 --- <br /> Application For <br /> PUBLIC VVORKS PERMIT P�������YlorwsFao — <br /> Tamicrr S— <br /> less Aoo� i���P���,� S <br /> e.,�,.,�.,•r.,��, 5 <br /> Print or Type Only <br /> Gary 2ah1 1405 Pine St Everett 98201 25: <br /> O�vne� �A4a�iin�7 Ar.Un�ss <br /> D Pedersen 259-7250 _____ _.__ ___ -- --- <br /> Applleant h� ,�I��r.; ndd�� e; <br /> new garage —- <br /> Describe Proposod Work -- – � -�---- <br /> �Ni71A� �HSPECTION <br /> -- ---- KIRK BROOKS W <br /> ProjectAddresslifknownf 1405 Pine St _ __.___ _ pA,t,� ,j �8- 95 � <br /> �� <br /> At�aCh fow (4)COP�es of PIan5lui P�uPwuJ wo�� - D�ar. to�c.il�. .in.i nr.�. � <br /> • Fronerty Lines <br /> • Outi ne and dimensions ol all existing and <br /> proJosed structures on thc lot / � �'/ � � <br /> � EMistina and proposed utildies �i� � <br /> � <br /> DO NOT WRIIE 6LL( / �l b . C, <br /> PERMITCONDITIONS (1�r1,v� , � <br /> 1.All calls for inspection shall be made 24 hrs.in advance•ph � /t' � v � <br /> 2.All work shall be performed in accordance with this permit a , <br /> StandardsandSpecifications. � �! ✓ � <br /> 3.Call Location Underground Service 48 hrs.before you dio.� /)� �� <br /> ( <br /> i'UdLli O <br /> •UBLIC 'hOHKS PEHUST ��EWlnt� <br /> i�,p( REOUIREw tY � <br /> eY___..__... .... ..._...__....__.�_ i:ATE. S Z � � <br /> � nTF. . ._._ � _._.___._.. <br /> �'UBUC WORKS PEPl�A�� ���yv � S�-'u'`�'"' /�''� O <br /> IrOf REOUIRE�! ���_� �,��� � � <br /> cv._�. ��, � 7,:�. <br /> �.+ATE_�_..._ -- ./1Ul.� � <br /> (� ACKNOWLEDGEPdENT OF CONDITIONS <br /> _��, �h�•unqr•r�iqned oe:ner!apphcaN hi�reUy agrees to hold and save harm� <br /> � — - — -- <br /> � n.s•, ;lu- i,ity o� Ev�?rett trom any and atl claims tor damages. cosls <br /> . ��y.en,es o� causes ol acuon Ihat may arise because ol m5tailaUon <br /> and �»�u��nnance nl thr ,mprovement or other nghPobway use he�eto <br /> ! aCpi�ed �or and lurther a9�ees to remove samr, upon nofice Irom Ihe <br /> qpproved lor Construction Da1e . C:'� .v;d iq replace Uublic p�opeiry damageC thereby. <br /> I <br /> FINAL INSPECTION , ���e I Datc <br /> Approved as Construded S�gnaiwe of Ano��can! <br /> j \'1'ORK i1U7tiORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> �Arl�� PUBLICWORKSDEPARTMENT I tA0 DAYS OP DATE PERMIT IS ISSUED ANO THEREAFTER IS TO <br /> 3200CedarSireet I 8E DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT tdAV BE <br /> C Everett,WA 98201 , C4"JCGLLED B'f THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259�8810 '�, FRO.IECT OVER 90 DAYS DURATION. <br />