Laserfiche WebLink
-- - - - --- (_ _- t _._ ,, ri <br /> Date ^ v�o���wo,w.ve,m��. <br /> � Biap.Deo�.• <br /> Application For <br /> PUBLIC WORKS PERMIT °°°To;:��eF" S � <br /> Less PDG�Fee Pa�O E <br /> Bal+nce Due S <br /> Print or Type Only <br /> Y1>>n Check No: B 49248 SEPA <br /> Applicat.Date: 08/17/95 Phone <br /> Owner � Job Addrese: 10413 3RD AVE SE <br /> Owner: LAKECREST CONSTR'J^TSOH <br /> Tenant� <br /> Yropoeed Uee: SINCLE FAMILY RESIDENCE . <br /> Appiicant Deec. of Work: Phone <br /> ADDITION <br /> Describe Proposed Work UFFICE SET JOB SET <br /> APPRPVED FOR PERMIT: DATE_/_/_ 8Y <br /> W <br /> , <br /> Project Address(il known) — — � <br /> Attach four(4) copies oi Dlans lor proposed work- Draw to scale and note the'ollowing as applicable�. o <br /> • Property Lines � Centerline of street /^ <br /> • Outline and dimensions ol all existing and • Indicate Norlh V� <br /> propo�eQ stiuctures on the lot • Show any prenosed grading changes <br /> • Existing and proposed utili�ies • Shnw measuremenls /�A <br /> DO NOT WRITE BELOW TIilS L'.JE � <br /> PERMIT CONDITIONS <br /> 1.RII calls Ior inspection shall be made 24 hrs.in advance-phone 259•8810. � <br /> 2.All work shall be pedormed in accordance with this G=rmit and current City of Everett Design and Cons[ruction <br /> StanJards and Specil�cat�ons. <br /> 3.�all Location Underground 3ervice 48 hrs.before you dig.TOLL PPEE tJUMBER 1•800-424•5555. � <br /> � O <br /> �O'C-�1/1 .. <�'�" �`�l���� � <br /> ! <br /> � - �C�i�t�., .. C ;!'-,_i � <br /> �'UBUC WORN� PEPM�, r, �'�' � �� . <br /> tvOt qE0U1PF� J ! �i; �4,µ,; l . /7," <br /> rv�B-- �.. ._. ���� { } ,.. ���� '' � <br /> +ATE_ .:g�� ��._.. . '�!�' , ( I�i� <br /> /x: /'<-x.� <br /> �t.� ��, .. s� , <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigncd owner/applicant hereby agrees to hold and saoe harm� <br /> — less Ihe Ciry of Evcrett Irom any and all claims for damages, cosis. <br /> expenses, or ca�..ses ol ac�ion lhat may arise because ol installation <br /> and maintenanr,e of Ihe improvemenl or other righPobway use her?to <br /> applied for anc Wrther agrees io remeve same upon nolice Irom �he <br /> Approved,'^r Cor.siruction �a�e Cily�nd to rep�ace public property damagetl thereby. <br /> FIN�L INSPECTION � Date Date <br /> Approved as Constructed Signature ol Applican; <br /> � WORK �UTHORIZFD BY TIiIS PERMIT Iv1U5T f3E STARTED WITHIN <br /> PUOLICNORKSDC-PARTMENT 78C DAYS OF DATE PERN.IT IS ISSUED AND THEREAFTER IS �TO <br /> '�r� 3200Cedar31ree1 B[ DILIG[NT�Y' PURSUED 70 COMPL[TION. THIS PERI.SIT MAY B[ <br /> Everett WA 98207 CANCELL[D '4Y THE CITY UPON AN'{STOPP.IG[OF WORK OIJ iHl:; <br /> P�one:259-8810 PROJECT OVI_R 90 D�'f5 DURAfIp,J. <br />