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/ <br /> Date 7-19-91 r��,���wo�k�v��m,�. �� 34Z . <br /> oiad oem . 91/27373 <br /> qpplication For — <br /> PUBLIC WORKS PERMIT P°°.o;,«p°°� § — <br /> � C] H� Loss aooi.��e Pa�a 5 <br /> [s� �atancaDue S 20 <br /> p�� Print or Type Only <br /> G � To PntT�N .r, ,� �� �; <br /> � HV� <br /> H � � Heal, Jerry Jr 2111 Rockefeller Ave Everett 98201 252-3193 <br /> y hi <br /> 1� C� Owner Mailing Address City Zip Phone <br /> y:U <br /> � �N Owner <br /> � „�, Applicant MailingAddress City Zip ohone <br /> , � d 322 SF <br /> � �"'� Describe Proposed Work Garaqe <br /> � �g <br /> �Y (7 <br /> zyy� <br /> rNH � <br /> y � 2111 RockeFeller Ave L <br /> ��N Prdect Address(il known) r <br /> ��r Atlach lour(4)copies ol plans for proposed work- Draw to scale anA note the toltowing as applicable: � <br /> K1 • Properry Lines • Centerline of strcet /^ <br /> y� y • Outlina and dimensions ol all existinc�and • Indicate North V� <br /> proposed structures on the lot • Show any proposed c�ratling change:; <br /> • Exis�ing and proposed utili�ies • Show measuremrn�s Y <br /> �W <br /> . UO NOT WRITE BELOW THIS LINE <br /> � PERMIT CONDITIONS O <br /> � 1.All calls tor inspection shall be made 24 hrs.in advance-phone 259•8810. � <br /> �� 2.All work shall be pedormed in acrordance wilh�his permit and current Ciry ot Everett Design and Consiruction <br /> Standards and Specilications. <br /> � 3.Call Location Untlerground Service 48 hrs.hetore you dig.TOl L FREE NU seA 1-800-424•5555. � <br /> , , L=� J��� <br /> 1 (1 �,� � � � <br /> r I 1 <br /> /!' <br /> / i � � <br /> � � � � ,�� �,�' � ��J �v;�,(s . - ::,- � <br /> �e -l�' � <br /> ��,,. <br /> U� � ��< «��o" <br /> __i Cf ���P `. ;E � �q ��os�: ; a <br /> 1� �� � .•,n :� �� <br /> � ` ' i <br /> '__ .,.-.. '� :�....�`.,,�:'. <br /> �t�'. � ACKNOWLEDGEMENTOFCONDITIONS <br /> _ � �� The undersiqned owner/applican�hereby ac�rees�o hold and save hann- <br /> less the Ciry ol Everett I�om any and all claims for damages. costs. <br /> c� ezpenses, or causes ol action th�t may arise because of installation <br /> ���-�-�'�-� "— ��—J I and maintenan[e ol the improvemenl or cther right�of waY use hereto <br /> applied lor and imther agrees to remov� same upon notice imm thc <br /> Approved for Construc �pn /- Date C�ly and to replace publlc property damaged Ihereby. <br /> / � <br /> "���, �' �_z ;- i Z- k (� ,c ��R,� � 9��'��� <br /> FINAL INSPECTION Date <br /> Approved as Conslructed S g�, Wre of ApplicaN Date <br /> � PUBLICWORKSDEPARTMENT WdRK AUTHORI2ED BY THIS PERMIT MUST BE STAfiTED WITHIN <br /> 'V�� 3200CedarStreet iB0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA 98201 BE DILIGHNTLY PURSUED TO COMPL[TION. THIS PERMIT MAY BE <br /> Phone:259�8870 CANCELLED BY THE CITY UPON ANV STOPPAGE OF WORK ON TIIIS <br /> PROJ[CT OVER 90 DAYS DURATION. <br />