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Date��ii� a.���,��vo,�.v�,m�. _�� <br /> oi.a ocoi .B��_- - <br /> App�icatlon For <br /> �n� Pl1gLIC WORKS PERMIT "°°'°,"°�YFeC -- - <br /> .o�.�F�� S- <br /> ay <br /> A`..J S �ess aoo�.�ee va�u 5__�-_ <br /> r CaCy oa�ar,:eDue 5 e�U� _'___'_ <br /> Print cr Type Only <br /> y z t�-� <br /> oxo �,1i N i2,,. I ; !- ,3 �u�Im�.�• R�cl �'�i�,Fi/ 7'�3-37.� 7 _. <br /> � �� Owner Mailmg Adtlress (.�ty Z�P ['n��;�.� <br /> C�H <br /> � o� ,�� P � �" z :s3zo -/9r+,�„ TG` '�Z,fkP�l z/ �S- d�l4+G -- <br /> O H� �,. � <br /> qPn�i���� Mailm9 Atldress Cdy Zip Phone <br /> � C=]� <br /> n� c� /U��cJ, S�� ��nin+�_l�—��.D-d!� Lcf 3 .SP /�n> -�F-h�7- <br /> z � Descrihe Proposed Work - <br /> 9 H� _. <br /> C : <br /> � �H <br /> O tC7[~A - � <br /> � '"r Prolect Atld�^ss I�f known) ��2�- /Sy �`�G�F.Sr. -. - � <br /> z y ti -- <br /> � O V� Attach low�4)copies of plans lor propoSCd worY� D:.�:. tn�.�:':,i,� ,����.f nrt••ro��t,�n��ying as apPlicablr � <br /> • Properly Lmes • p�.nledme of;treet /^ <br /> • Outlme and tlimens�ons o�all u+�sl•np:n��1 • Ind�c�le Norih V� <br /> prOpoSed SlruGtureS on Ihp Ipt • ti0o�v�cy preposed 9iah�����Cha��q��s <br /> • Exisim9 and p�eposed uLhtu�s • Shon incasuremenls /�/A <br /> W <br /> 00 N��1 '::HITF EiRO\V i1115 LWL o <br /> .�.` PERMIT CONDITIONS <br /> � � 1.All calls lor inspection shall be made 2a hrs.�n atlwnce-phone 259•881 O ^ <br /> �� 2.All work 5hall hC pedo�m2tl in aCeartlanCe wiih ihis permi�antl curreni Cdy n! 6en.�It D�^.,�gn.+nd Consnuction ♦ <br /> Sla��de�ds and SpecJic���ans <br /> � e.Cnll Locanon UnCriqi�:un�1 5• �:�',e�D h�•. b��!or�ynu r1�p TOLL FREE NUMBER 1•BOO-G24•SSSS. � <br /> E � <br /> �� �i� O <br /> ��� <br /> �A � � <br /> �I <br /> �.�� ' <br /> O <br /> a <br /> �- <br /> I,� ACFNONLEf7G1:M17ENTOFCONDITIONS <br /> Tho untl�,�signetl ownnVnppimant heicl�y o�rees Io hold MA save hain�� <br /> -- tess Ihe Cdy ol Everetl liom any antl all claims far Aamnnc:. rasls. <br /> expenses, nr causes ol nclion Ihni may anse her,au5e o� ���sCdlaUon <br /> � � ��� � �� and maintennnce of Ihe improvement or olher ngh4ol-waY ��;�' hrrrt�� <br /> �ppGeA lor and �wlher a9mes to removn same upon nabce Irnm Ih�� <br /> Apnrove�ocFon Date GIY and to replace n��bhc propeitY dama�ed theirby <br /> /� � r <br /> /� -�s',-�-���- /r'��? ����i t' � -.c. ,ti .c <br /> RIJl.L INSPECTION ` / �1�� -�-�--�-- - "-"-- - <br /> ppprovetl as Consiructetl pnatur 61 Appli aM �����' <br /> WORK UTHORIZED THIS PERAt1T MUST BE STA(7iE0 VJIiHIN <br /> r���,�i•�� AUBLICWORKSDEPARTIdENT 1F30 DAYS OF DATF: P[RA11T IS ISSUED ANU iHER[AFTER IS TO <br /> � 3200 Cedar Street BE DILIGENTLY PURSUED TO COM1IPLETION. TFiIS PER�1R 61AV B[ <br /> Evcrelt,WA98201 CANC[LLf'D CiV 1i��- CITY UPON ANY STOPPAGE OF l^JORH ON THIS <br /> Phanc.253�6810 PRO.I[Cl O:'LH 9U I)A�'S DUR�1110N. <br /> : <br />