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_ v _ <br /> _ / <br /> . �a�•�«,�« ii/so/9a. ' <br /> � PU�LIC WORKS PERMIT °°'° - <br /> PUBLIC WORKS DEPARTMENT Publk Works PermN k�'- o <br /> 32°°�°de`st�t -'60962 <br /> Evaretl,WA 98201 2F3-8810 3uilding Pertnit N — <br /> NOV 1 6 � Publfc YVorks Fee 5.��.� <br /> TYPEORPRINTONLY �� POSTING �-�'"" :; <_` ;, , __ <br /> ;'> n: � , .. , ,_ <br /> ��,; . ., ,. . , .� . ;: <br /> JOHNSON DENNIS 135i5 212TH ST SCIry;SN OMI9H �P8296 360-P�Z313 <br /> ��� Meiling Address � <br /> .r.� <br /> ,�1 _i .i c:: ,, .' <br /> APPlicant MeilingAddiess C�i �-i -i i,i �,� � � v i.�; ��.' Phone <br /> �n � T - c� <br /> Describe Proposed Work NEW HOUSE W <br /> � <br /> � <br /> � <br /> PROJECT ADDRESS('rf known) 3425 NORTON AVE m <br /> Apach tour(4)copies of plans tor qoposed work•Drew to scale end note iM folbwing if appl�able: u,"�� O <br /> �property llnes 'Outline and dimensions of all existing and proposed structures cn the bt 'Exisling and proposed � <br /> 'Centerline ot street •Indiwte North 5how any proposed greding changes 5how measuremenls <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: <br /> 1.All calls for inspection shall be made 24 hours in advance-phone 259-8810. O <br /> 2.All work shall be performed in accordance with this pertnft and curtent City of Evert3tt Design and <br /> Construction Standards and Specifications. � <br /> 3.Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-6666• <br /> �, 'K�P I�c� Pxo�.n av�cQ�o,r c�+ra�d s;dewAlk w;� �� N <br /> S��'Gwa�K ('e�' G�.l sk�cnn�crd �h� '� � 0 <br /> -�i� {le�, G�,�S,� �-.er,�s �� or� T�bl -�tvt�f, �. <br /> � J' 1 ACKNOWLEIX'iEMENT OF CONDITi0N5 <br /> p The undersigned ownedapplicant In�ebY BBrees to hWd end seve harrt�a <br /> / /l `� ��(/' 7� Me CIH of Everett hom anY and all claims for damages.costs,expsnea�ar <br /> causes of ectbn that may arba because ot fnstalatbn��°� <br /> Approved for C truct Dat ��mprovement or other�ight-of-weY we herero�pibd <br /> C��,y to remove seme uoon notkre hom the CRY end to roplace{wbWc P�M�b <br /> y � - �S// dema9edtherdry. <br /> F,ivAL INSPECTION ��— ^ `/�7 � /_ /_ ,/L <br /> Approved as Constructed �/��y� !pyy.�.�L fJ 7Y � <br /> Sig�ature ol Applican �B <br /> COMPLEfION.RTH SDPERMfT MAY BE CANCELLEDTBY THE CINIUPON ANY STOPPAGE OF WORK ONUTHIS DPROJECTOVEp 90 DAYS pURAT�aJ'Y WRSUE�TO <br />