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! �- <br /> � /. � ~`-� pueim v+ada Permn• <br /> " Date omu oeo�.• <br /> Applicalion For _ <br /> PUBLIC WORKS PERMIT PubiiclYoikaFea <br /> totai Fee g <br /> Lesf Aoo��Fee Pa�E 5 <br /> Balance�m 5 <br /> ��� Prinl or Type Only <br /> t�7 <br /> 9H <br /> A x H SEPA <br /> 9 y y Plan Check No: B 38098 Phone <br /> Applicat.Date: 09/22/92 Z'p <br /> H � Owner Job Addreee: 29Y1 RIVERVIEW RD <br /> y �y Owner: CHARLES SUSAN <br /> K n Tenant: <br /> H�l Propoaed Uee: SHEJ/SFR z�p Fhone <br /> � �,x„i,.�� Applicant Desc. of Work: <br /> y�,,,� SHED AOOF <br /> � n� Descri6e Proposed Work OFFICE SET JOB SET <br /> y <br /> APPROVE❑ FOR PERMIT: DATE_/_/_ BY <br /> � �g W <br /> y�V � <br /> z �� L� <br /> � �„�y Pwiect Address(il known) r <br /> gy H Attach lour(4)cooies ol plans lor proposed work• D�aw to scale and note lhe lo�lowing as applicable: � <br /> n d y • Property lines • C�ntedine ot street <br /> ��r • Indicate North <br /> • Outline and dimensions ol all exisling and � Show any proposed grading changr: <br /> y y proposed sirucWres on�he lot • Show mezsurements � <br /> y �y • Existing and proposed utililies <br /> DO NOT WRITE BELOW THIS IINE O I <br /> PERMIT CONDITIONS � <br /> 1.AI�calls for inspection shall be made 24 hrs.in advance-phone 259-8810. <br /> 2.All work shall be peAormed in accordance wilh lhis permit and curreni Ciry of Everelt Design and Constmction <br /> Slindards and Speciticalions. � <br /> � � /J <br /> 3.Call Locatinn Underground Service 48 hrs.belore you dig.TOLL FREE NUMBER 1-800�424-5555. <br /> ' ' /'L-�[Jt:cc � 4/c—r��.�f�v>.,,.� /L'c7�.:^rf'.tGc��t-�rf' O I <br /> �w _� `J �,3 -� Z ~ � <br /> ..�.,.r <br /> �/ I <br /> 1 O <br /> ' ' ( <br /> I <br /> I <br /> �='...' It <br /> I ACKNOWLEDGEMENT OF CONDITIONS <br /> � s <br /> 7he undersigned owneqapplicanl hereby agrees to hold and save arm� <br /> _—. less 1he Ciry ol Everell Irom any and all claims loi damages, cosls, <br /> ' expenses, or causes ol action lhat may arise because ot installation <br /> and mainlenance ol lhe improvemenl oi other righ4of�waY use hereto <br /> �'! applied lor and lurther agrees lo remove same upon notice irom ihe <br /> Approved lor Consiruction Date Cily and lo replace public property damaged ihereby. <br /> FINAL INSPECTION Dale Date <br /> Sic�nature��APPlicant <br /> ApOro�ed as Constructed <br /> � WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHI <br /> � PUBUCWGRKSDEPARiMENT 1B0 DAYS OF DAT[ PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 Crdar Slrecl BE D�LIGENTLY PURSUED TO COti1PLETION.THIS PERMIT MAY BE <br /> Everelt.WA 98201 CANCELLED BY THE CITY UPO�.ONY 5TOPPAGE OF�YORK ON THIS <br /> ahone�259�8010 PROJECT OVER 90 DAYS DUAnT1C1N. <br />