Laserfiche WebLink
� y I <br /> p� � . . . <br /> � Hm <br /> �� � . � zv-��_ � , _. <br /> H C�C Date �-` a�ou�wo,w,va�m�i. <br /> �H O Application For ema.oeo��• <br /> M1 <br /> y Puoi¢wo�b Poe <br /> PUBLIC WORK PERMIT to,�,F�e s <br /> �O� Lb�a ApD�Fee PaiO $ <br /> H <br /> �o�� Print or Type Only B��a��,o�e a <br /> o• <br /> Plan Check No: C 38660 SEPA <br /> �� Applicat.Date: 11/10/92 <br /> t�M Owner Job Addresa: 2523 PZNE ST <br /> W H Teant: MILLER CRAIG 6 CATHERINE Zip Phune <br /> �� Propoaed Uee: SINGLE FAMILY RESIDENCE <br /> Deec. of Work: <br /> � qpplicant ADDITION/BEDROOH & BATH Z{p Phone <br /> '-� �y� Describe Proposed Work �FFICE SET JOB SET <br /> APPAOVED FOR PERMIT: DATE_J_/_ 8Y . <br /> W <br /> Project Address(if known) � i <br /> Attach lour(4)copies oi pians for proposed work- Draw lc scale and note the following as applicahle: � <br /> • Properry Lines • Centerline ol streel � /A <br /> • Outline and dimensions ot all existing and • Indicate Norih V� <br /> proposed struclures on the lot • Show any proposed grading changes <br /> • Ezisting and proposed utilities • Show measurements � � <br /> DO NOT WRITE BELOW THIS LINE I <br /> '�' PERMIT CONDITIONS O <br /> ' ' 1.All calls lor inspection shalt be made 24 hrs.in advance•phone 259•8810. � <br /> 2.All work shall be peAormed in accordance with lhis permit and current City of Everetl Oesign and Construction <br /> � Standards and Specllicalions <br /> '�1 3.Catl Location Untlerground Service 48 hrs before you dig.TOLL FREE NUMBER 1-800�424•5555. � <br /> �_I Q � <br /> 1-1 � � � <br /> I�' ";. �' PUBLIG WORKS PERMIT I_ <br /> NOT REOUIRED r�� � <br /> ` � \I r <br /> I I B Y �71.�' / O ',, <br /> � � � DATE /��-%- - I <br /> � <br /> � a � <br /> � <br /> �' ACKNOWLEDGEMENT OF CONDITIONS <br /> 1� The undersigned owner/applicant hereby agrees to hold and save harm• <br /> less Ihe City ol Everett Irom any antl all c�aims lor damages, costs, <br /> � expenses, or causes ol aclion t�at may arise because ot installation <br /> � and maintenance ol Ihe improvement or olher righPol�way use hereto <br /> applied lor and furiher agrees to remove same upon notice Irom the <br /> Appro�ed for Construc�ion Date City and to replace public properly damaged thereby. <br /> FINAL INSPEC710N Date <br /> Approved as Constructed Signature ol Applicant Date <br /> i� PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> ia��e� 3200CedarStreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everelt.WA9B201 BE DILIGENTLY PURSUEO TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:259•8810 CANCELLE�BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS �URATION. <br />