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r � " I Puenc wa.��Parmn• <br /> Date � _ , �1 emv o�o�.. 3G���?�— <br /> Application For <br /> PUBLIC WORKS PERIUIIT PuoncworxaFe� <br /> Tot+l Fee s <br /> Leas�Col Fea P+�a S <br /> Bn�ance0ue S <br /> Print or Type Only <br /> Plan Check No: ➢ 36224 SEPA <br /> Applicat.Date: 04�03/92 <br /> Job Addrees: 11 29 2ND AVE SE �;p Pnone <br /> Owner Owner: MCKINLEY, DAVID S <br /> Tenant: <br /> Proposed Uee: SINGLE FAHILY RESIDENCE <br /> Deec. of Work: .�p Phone <br /> Apolicant CARAGE WITH LIVING SPACE ABOVE <br /> OFFICE SET JOH SET <br /> Descrihe Proposed Work _ — <br /> APPROVED FOR PERMIT: DATE_/_/_ BY <br /> W <br /> Project P.ddress(iF known) � <br /> � <br /> Attach tour(4) copies ot plans for proposed work- Draw to scale and note the lollowing as applicable: � <br /> • Property Lines • Centerline of slreet <br /> • Outline and dimensions of al1 existing and • Indicale North <br /> proposed structures on the loi • Show any proposed grading changes <br /> • Existing and proposed utilitiea • Show measuremems M <br /> W <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS � <br /> 1.All calls lor inspection shall be made 24 hrs.in advance•phone 259•8810. <br /> 2.All work shall be perfnrmed in accordance with this permit and current Ciry of Everett Design and Construction <br /> StandarGs and Specitications. - � <br /> 3.Call LocTtion Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800•424-5555. <br /> O <br /> � ' � - . . . . „ �w <br /> , <br /> / � �/ <br /> � ' 1' O <br /> Y'�..� � _ !,i ' � <br /> a <br /> ACrCNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby egrees to hold and save harm� <br /> less ihe City ot Everelt Irom any and :.II claims lor damages. costs. <br /> eapenses, or causes of action that may arise because ol installation <br /> and m2intenance ol ihe improvement Or other righbOhway u5e hereto <br /> apPlied for and lur�he� agrees to remove same upon notice Irom ihe <br /> � .�r.pwvrd for Construction Date City antl to replace public property damaged thereby. <br /> FINAL INSPECTION ���e Date <br /> Approved as Constructed Signature of Applicanl <br /> � WORK AIiTHORIZED B\' THIS PERMIT MUST BE STARTED�WITHIN <br /> � PUBLICWORKSDEPARTMENT 1B0 DFYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> /.�'�'� 3200 CeCar Street BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> A�� Everett.WA 90201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Pnone:259�e�t0 PROJECT OVER 90 DAYS DURATION. <br />