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A x! x <br />9Hv� <br />H�� <br />� H� <br />"�U N'� <br />L9 H <br />x <br />��d <br />�/��g <br />y� V C] <br />t' y � <br />HH <br />g �' <br />�dC� <br />�yy <br />HOV� <br />Date_ <br />' �pplication For <br />� PUBLIC WORKS PERMtT <br />Publlc Wo�ka Pormll � _ <br />pldQ Don�� • <br />PuL1�cWa�bPoa S — <br />.m�� ree <br />Less �Do� Poe Pnitl s <br />Belance Ove S _ <br />Print or Type `� plan Check No: B 27317 <br />. Applicat.Date: 07/11/9l. <br />' Job Addrese: 144 E MAAINE VIEW �R <br />; Sepa Number: <br />Owner: EVERETT PARKS 6 A�C DEPT ZiP Phone <br />� Owner Proposed Use: CLUBHGUSE <br />Desc. of Work: <br />FILL IN ROOF AND FACLOSE 690 SF ADDITION <br />Applicant OFFICE SE'P JOB SET <br />APPROVED FOR PFRMIT: DATE_/_/__ By <br />Descri6e Propc <br />Prolecl Address �il known) <br />— Zip Pho�o <br />Attach lour (�) copies o� oi��ns lor proposed wo�k - Draw to sca�e and nole the lollowing as app�icnbl�: <br />w Properly Lires • Cenledine ol slreel <br />• Indir,ate Norlh <br />• Out'Inc an9 dimensions of ali ealsling and � Show any proposed grading changes <br />propo-ed o��uclures on ihc lol � Show mcasurements <br />• Ezl• P�g and propOsed utllili�s <br />� � PE:iM1T CUNDITIONS <br />� 1. All calls lor inspectlon shell be made 24 hrc. in ndvnnco � phona 259•8810. <br />�� ' 2. All wark shall bo ped�rmed in accord�nce wllh Ihia permit nnd cwrenl Cily ol Everell DeslBn nnd Conslrucllon <br />� � Standards end Sper.ilicalions. <br />3. Cell Location Vnd�rgrounJ S^rvico 4� hrs. betore you dig. TOLL FREE NUMBER i-800•424-5555. <br />� � � � �y� ��- <br />� Cv�z��'— �.sttiY,,.�-� � r `'1 � <br />t <br />y� <br />; <br />�,.z_yi <br />qpproved for C �nslmction Dato <br />FINAL �NSPECTION D�te <br />Apprmed ns Conslrucled <br />PUOLIC WORKS DEPARTMENT <br />� 9200 Cader Slrcet <br />Evcratt, WA 98201 <br />Phone: 259�8810 <br />x <br />U <br />� <br />� <br />Y <br />� <br />C <br />� <br />�` <br />i <br />C <br />r <br />� <br />c <br />G <br />ACKNOWLEDGEMENi OF GONDITIONS <br />The andersinned ownor/rpVlicaN horeby ngrees to hold and seve he� <br />less tho City ol Everetl Irom any and all claims lor damages, coe <br />oxpenses, or causes ol nctlon Ihal may arise 6ecause ol Inslalleti <br />nnd innlnlen�ntc ol Iha improvemenl or alher dghl•o4wey use heu <br />opplied lor �nd lu�lher ngreos lo remove snme upon oolice Irom t' <br />Cily nnd lo repinw publlc properly dameged �hereby. <br />Signaluie ol A��lir.anl DA�e <br />BO�D� STOO�DATE Pf.RMIT ISEISSUED AND TNE EAFTER IS � <br />BE DILIGENiLY f'URSUED 10 COMPLF.TION. THIS PERMIT MAY � <br />CANCELLED BY THE CI1Y UAON ANY S70PPAGE OF WORK ON 71' <br />PROJECT OVER 90 DAYS DURATION. <br />v� <br />