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� � <br />� <br />�Hay <br />Hx� <br />�! t� <br />pH� <br />�1H� <br />N <br />H� <br />OHd <br />��g <br />�Y n <br />t"y� <br />h-� y <br />gy <br />C]�V�i <br />�O� <br />� <br />� <br />Datc> >��sL <br />, -�w <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />aeLc Wo�l.s Permn . <br />Biao. Deot. a � '� 4 '7 ,S' <br />Publ¢ Wa�ks Feo <br />Total Fee S <br />Les� nco� Fee ve�e $ <br />BalenCB Du! S <br />Plan Check No: B 37478 SEPA <br />Owner Applicat.Date: 07/23/92 Zia Phono <br />Job Address: 1628 PUGET DR <br />Owner: SABROWSKY LIVING TRUST <br />Tenant: SI+BROWSKI, RON - <br />Applicanl Proposed Use: SINGLE FAMILY RESIDENCE Zip Phone <br />Desc. of Work: <br />COVERED PATIO ROOM <br />Describe Proposed WorV <br />OFFICE SET JOB SET <br />APPAOVED FOR PERMIT: DATE__/_/_ gY <br />Project Address (if known) <br />Allach lour (4) copies of plans tor proposed work • Draw to scale and note Ihe lollowing as applicable: <br />• Property Lines • Cenledine of streel <br />• Outline and dimensions ol all ezisting and • Indicate North <br />proposed siructures on the lot • Show any proposed grading changes <br />• Ezisting and proposed ulilities • Show measuremenls <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be mede 24 hrs, in advance • phone 259•$$10. <br />2. All work shall be performed in accordance with this permit and current City ol Everett Design and Construction <br />Standards and Specifications <br />3. Gall Locatlon Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1•800•424•5555. <br />�- f U6�r. u�nj =�'u��. ,�.Z' , '=T',C��.,..__, �.. ( <br />d" <br />Approved lor Consiruction <br />FINAL INSPECTION <br />Approved as Conslructed <br />�PUBLIC WORKS DEPARTMENT <br />3200 Cedar Slreel <br />Everclt, WA 98201 <br />Phone:259�BB70 <br />Date <br />'1�_J <br />-2 `1 `i [ <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />F- <br />N <br />� <br />O <br />The undersigned owner/applicanl hereby agrees to hold and save harm• <br />less the Ciry ol Everetl Irom any and all claims lor dama9es, costs, <br />ezpenses, or causes ot aclion Ihat may arise because of installalion <br />and maintenance of Ihe improvement or other right-ol-way use herelo <br />applied for antl lurther agrees to remave same upon notice Irom ihe <br />City and to replace public property damaged thereby. <br />Signalur� olApplicanl Date <br />WORK AI,THORIZED BY THIS PERMIT MUST BE ST�RTED WITHIN <br />180 DAYS UF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCEILED BY THE CITY UPON ANY STOPPAGE 7F WORK ON THIS <br />PROJECT G'!ER 90 DAYS DURATION. <br />