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._._— -----�� <br />� <br /> f <br />` � <br />� /�( �7—z9-s <br /> Date� I <br /> Pu01ic WorM�p��m11� -� <br /> Application For eieo.oao�• <br /> PUBLIC WORKS PERMIT Puei�eWorhaFea <br /> Tohl Fe� S��� <br /> LH�AOGI Fee PUE S�� i <br /> Print or Type Only Plan Check No: B 46650 SEPA au,��•o�. S� I <br /> ApplicaY.Date: O1/OS/95 -_ <br /> Job Addresa: 1223 MAPLE ST <br /> Owner: DHAMI ICHAJAN <br /> Tenant: <br /> Propoaed Uee: SINGLE FAMILY RESIDENCE <br /> Owner Desc. af Work: <br /> 2ND STORY ADDN ��p Phone � <br /> Applicant OFFICE SET JOB SET <br /> APPROVED FOR PERMIT: DA�E '�P Phone <br /> ._/_/_ 8Y <br /> Describe Proposed Work _ <br /> Pro�ect Address(if known) � <br /> Attach four(4) copies of plans (or proposed work- Draw to scale a�d note the following as applica6le: � <br /> • Property Lines • Centerline of street <br /> • Out�ine and dimensions ot all existing and • Indicate North � <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Extsting and proposed utililies • Show measurements <br /> DO NOT WRITE BELOW THIS LINE � <br />' PERMIT CONDITIONS O <br /> 1.All calls for inspection shell be mede 24 hrs.(n advance-phone 259-$$10. <br /> 2•All work shall be performed In accordance wfth thfs permit and curtent City of Everett Design and Construction � <br /> Standards and Specifications. <br /> 3.Call Locatfon Underground Service 48 hrs,before you dig.TOLL FREE NUMBER 1•$00�4Q4•5555. cj� / <br /> �yJ ��� 2 � I� Z <br /> r r/�-� e�o-�--�z..,�� , ,_-�;,�,`'u,����`��;s%� +�,�, � <br /> /�'� �c�i.�.c�c.�� � .� V�'�' �� ° o� �� '"" <br /> 0 //� <br /> � �y �n.ua� pC�.-.P�� � �/r <br /> .��, . <br /> �� �� � 7`o UP 9faa/e S¢u/e r / O <br /> . . P� �„��Y ��,�d,;,,� _ �' a <br />, - __= <br /> � <br /> ACKNOWLEDGEMENT OF CONDITIONS <br />' 7he undersigned owner/applicant hereby agrees to hold and save harm• <br /> . less the City of Everett Irom any and all claims for damages, costs, <br /> expenses, or causes of action that may arise because of installation <br /> and maintenance of the improvement or olher right-of•way use hereto <br /> Approved for Consiruction Date applied for and further agrees to remove same upon notice from the <br /> City and to replace public property damaged thereby. <br /> FINAL INSPECTION Dale <br /> Approved as Constructed Signature of App�icant <br /> Date <br />� ��rl� PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CedarSlreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS �TO <br /> Everetf,WA 9g201 BE DILIGENTLY pURSUEO TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:259-8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER g0 DAYS DURATION. <br /> I <br />