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Date � P�o.�we,..>.,m,�. <br /> Applicatlon For e�aa oeo�• <br /> PUBLIC WORKS PERMIT �^°�w�,.,�.. <br /> ro�.�... s <br /> t�n eoo�rn r�m 3 <br /> Print or Type Only ��•:.o�. f <br /> Plan Check No: C 39817 SEPA <br /> Applicat.Date: 03�09/93 <br /> Qw Job Atldreee: G4 3 RIDCEMONT DR Phone <br /> Owner: ZELINSICI HICHAEL <br /> Tenant: <br /> Propoeed Uee: SINCLE FAHILY RESIDENCE <br /> _ Deec. of Work: <br /> A�P��"�� BNEARFASTR�M ��ER GAAAGS� 1 ROOM OVER P�one <br /> Destrice Proposed Wark _ OFFICE SFT JOB SET <br /> APPROVED FOR PEAMIT: UpTE_/_�� gy <br /> W <br /> Projecl ACtlress(il known) � <br /> Allach lour(4�coples ol plens b�proposetl work•Oraw to scale antl nolo Ine lollowing as applicaEle: � <br /> •Prope�ry Lines •Cenlatline ol s�reel � <br /> •Outline and dimonsions ol all existing anE •Intlicale Norih <br /> proposed structures on Ihe lol • Show any proposed gratling c�anges <br /> •Erisling and proposed utllitles •Show measuremenls � <br /> DO NOT WRITE BeLOW tMIS LINE O <br /> PERMIT CONDITIONS <br /> 1.pll cnlls lor Inspectlon shall 6e made 24 hrs In advance•p�ona 259•8810. � <br /> 2.All work shall be perlormetl in accordance with ihis permil and cunent City ol Everelt Design anE Constructlon <br /> S�andard9 antl$peCIIlCailons <br /> 3.CeIILocatlonUndergrountl5ervice48hrsheforeyoutlig.TOLLFREENUMBERI•800•424•555$. � <br /> O <br /> � <br /> PUBLIC WORKS PERMIT /A <br /> NOT REOi11RED V� <br /> BV ' ' O <br /> DATE � /2 `�� _ � <br /> ACKNOWLEDGEMENT OF LON�ITIONS <br /> T�e untlersignetl owner/aOPlicanl�ereby agrees to�old and save�rrm� <br /> less Iho Cily ol EvereU Irom any and all claims lor Eamagea <osl; <br /> ew0enses, or tau:es ol action Ihat may a�ise because ol installation <br /> and maintenance ol Ihe impmvement or ot�er rigbPo4way uee�ereto <br /> FpprOveA Ior Consi�uclion applietl lo�2n0 lu�t�e�agrECs t0 remOvO Same upOn nolice Irom Ihe <br /> Dale Cily and to replace public propeny Oamaged Nere�y. <br /> fiNAL INSPECTION Dale <br /> .+nn�o�ee as consvuctea SlgnaWr¢OI APPIiC2ni D2te <br /> � PUOLIC\YOHKSOEPARTAIENT �'�'ORK AUTHORIZEO BY THIS PERMIT MUST BE STARTE�WITHIN <br /> '� 3200CedarStrccl 180 OAVS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everet�WA9B201 BE DILIGENTLV PURSUED TO COMPLETION.THIS PEPMIT MAV 0E <br /> P�ono:259�8B10 CANCELLED BV THE CITV UPON ANV STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAVS OURATION. <br />