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� ^vm�c wo,h�vermu• <br /> Date <br /> Oltlp.00DI� <br /> Applicalion For <br /> PUBLIC WORKS PERMIT PUDheWor4aFee - <br /> To1�IFee g <br /> Lest AooL Fee Pa�C 5 <br /> B�bnce Dae S <br /> Print o�Type Only <br /> Plan Check No: B 45703 SEPA Phone <br /> Owner Applicat.Date: 09/29/94 <br /> Job Addra: 111b1 1ST DR SE <br /> Owner: HILLS ROSEMARY <br /> Tenant: — <br /> Applicant Propoeed Use: SINGLE FAMILY RESIDENCE Phone <br /> Deec. of Work: <br /> GREENHOUSE ADDITION <br /> Describe Proposed Work <br /> OFFZCE SET JOB SET <br /> APPRVD FOR PERMIT: DATE_/_/_ BY <br /> W <br /> Project Address(il knownl � <br /> � <br /> 4tlach tour(4) Copies ot plans lor proposed wurk� Dra'v.� to sr.al•� a:+tl ncle tne fo�lcwing as apUlicable: � <br /> • Property Lines • Cenlerline n�streel � <br /> • Outline and dimensions of all existing and • indicate North <br /> proposed slructures on ihe lol � Shcw any r,roaosetl gratling changes <br /> • Existing and proposed utilities • Show measurements /� <br /> W <br /> i DO NOT WRITE BELOW THIS LINE O <br /> ' PERMITCONDITIONS � <br /> ' t,All calls for Inspection shall be made 24 hrs.in advance•phone 259•8810. <br /> 2.All work shal!he peAormed in eccordence wilh this permil and wrrent City of Everell Design and ConstruUion <br /> Stendards and Specifications. � <br /> 3.Call Location Underground Service 48 hrs.betore you dig.TOLL FREE NUMBER 1•800•424•5555. <br /> � <br /> � <br /> pueLlC WORKB P@lIMIT � <br /> NOT REDUIRE� <br /> '"� OAATE � " <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersignetl ownedapplit2nt hereby ag:�es lo hold and save harm� <br /> --' � less Ilie Cily ol Everetl lrom any and all claims tor Gamages. cosls. <br /> � ezpenses. or causes ol aclion that may aris^ because of insiallation � <br /> � and mamtenance o! the improvement or other righFobway use herel� <br /> Iappi�eC lor and lurther agrees lo remove same upon notice Irom the <br /> �roved for Construclicn Dale � �,;��.�„� to replace public properry damaged thereby. <br /> i <br /> IAL INSPECTION � Date I Date <br /> xoved as Constructed Signature ol Applican! <br /> V✓ORK AUTHORIZED BY THIS PERMIT MUSi BE STARTED WITHIN <br /> r� PUBLIGWORKSDEPARTMENT tA0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 Ceder5lreet ' BE DILIGEN?LY PURSUED TO COMPLETION.THIS PERMIT 1.AAY BE <br /> Everetl,WA 98201 GANCEILED BY THE CI i Y UFON ANY STOPPAGE OF WORK ON THiS <br /> Phone:259•8810 PROJECT OVER 90 DAYS DURATION. <br />