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R� <br /> ,<' ?- z , <br /> Date F - � P�o����.�o,k.P��m��. <br /> � Diao Oeot• <br /> ��� Application For � <br /> PUBLIC �IVORKS PERMIT Puoi¢woreaFee <br /> a y TolelFee � <br /> ��x Lese ADoI Fee PaiO S <br /> I � H <br /> BaianceDae � <br /> �"a' xy Print or Type Only <br /> y yg <br /> z <br /> K � <br />� Q x� Plan Check No: C 39510 SEPA <br /> .� H.�y Applicat.Date: 02/08/93 <br />' CAH Owner Job Address: 1223 MAPLE ST Zip Phone <br /> H r Owner: DHAMI KHAJAh <br /> x Z 3 Tenant: i <br /> �� y d Proposed Use: SINCLE FAMILY RESIDENCE <br /> � � Applicant DeBc. of Wo[k: Zip Phone � <br /> 2B8SF BEDROOM/BATH ADDN � <br /> �^ �g <br /> M•y � <br /> Describe Propose OFFICE SET JOB SET <br /> �.9..i y y. _ APPROVED FOR PERMIT: DATE_/__/_ gY <br /> HH <br /> y W <br /> H <br /> C7 t7 y <br /> � �" �- <br /> z y y Project Address(if known) <br /> y �y AUach lour(4)copies o� Plans br proposed work� Oraw to scaie and note Uie lollowing as appliwble: � <br /> • Property Lines • CeNerline ot streel ♦^ <br /> • Outline and dimenslons ol all existin9 and • Indicale North V� <br /> proposed siructures on Ihe lot • Show any proposed grading changes <br /> • Exisling 2nd proposed utilitie5 • Show measurements /y� <br /> W <br /> � DO NOT \Vf�ITE BEIOW THIS LINE � <br /> ''�� PERMIT CONDITIONS <br /> ..�� 1.All calls tor inspection shall be made 24 hrs.in advance-phone 259•8810. � <br /> 2.All work shall be pedormed in accordance with Ihis permit and current Ciry ol Everett Design and Constmction <br /> Standards and Specilications. <br /> `f �.' 3.Call Location Underground Servico 48 hrs.belore you dig.TOLL FREE NUMBER 1•800•424•5.`�i55. � <br /> a� <br /> PUBLIC W�RK`' PERMIT O <br /> ` — - - _ NOT REOUIRED <br /> BY � ' "�� � <br /> )Nt�I7Ct ��SPEKSIOt� ` _ <br /> �� KIFiK SR�Q\� \ , DATE � � ♦/� <br /> �' ' __\ \`\ .... ... y`./ 1' .•.�.., �.(��L ��l��i �l 1��,_ �. �� <br /> �/ � O <br /> �u , <br /> e nA�r�� �, `, ._. : .-. _,��..� �'/� -�':..,— <br /> � �""' ,�, �;,� �.. <br /> -�� �:.��.�,� �L��.�� �, �. a <br /> '.,�. , '� _ ,. �' � �». E r � ��� <br /> i <br /> "�� ACKNOWLEDGEMENT OF CONDITIONS <br /> The untlersignetl owner/applicant hereby a9rees to hold and save harm� <br /> less the Ciry of EvereU irom any nnd all claims br damages, costs, <br /> • expenses, or causes o1 action �hat may arise hecause of installation <br /> and maiNenance ol Ihe improvei,�ent or other righ4ol�way use hereto <br /> applied lor and lurthcr a9rees lo remove same upon notice Irom Ihe <br /> Approved for Co��sVuction Dale City and to reploce pu6lic proPerty dama�ed Ihereby. <br /> FINAL INSP[CTION Date <br /> Approved as Constructed Signalure ol ApGlicant Dale <br /> PUBLIC WORKSOEPARTMENT WORK �UTHORIZED BY THIS PEP.MIT MUST Bt STARTED WITHIN <br /> 1f30 �AYS OF DATE PERI.IIT IS ISSUED AND TIiEFEAFTER IS TO <br /> ���� 32o0CedarStreet �E DILIGENTLY PURSUED TO COMPLETION. THIS PEFMIT MAY BE <br /> [vcrelt,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259�BB10 PROJECT OVER 90 DAYS DURATION. <br />