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, <br />� '• � � �F���l���`�' <br />�, !;''���I��� `���f,���� <br />�;;y of Everetl Public Works Department <br />� '� 3200 Cedar Street <br />l��� ,-,�r� Everetl, VVA 98201 <br />�� � (425) 257-8810 <br />i: <br />\ ' <br />., ..i <br />OWNER NAME AND ADDRESS: � <br />GILBERT LONNIE 8 JEANNIN[ 0� <br />� <br />112�2 ROOSEVELT VVAY NE r� ;� <br />S�AT'LE Wq `. 12� V <br />PHONE: 2065126218 <br />�AX PARCEL ID N 2°0424001011 CC <br />DESCRIPTION OF PROPOSED WORK: <br />CHANG[ OF USE-SFR l"O DIFT CCNTER <br />Date: <br />Pubi�c VVorks Permit i#: <br />Buildinq Permil #; <br />Planning Reference #: <br />Public Warks Fee S: <br />Olher 5: <br />APPLICANT NAME AND ADDRESS: <br />PHONE: <br />SITE ADDRESS: 10013 4TH AVE W <br />2128/2012 <br />PW1207 219 <br />C12Q2 OG5 <br />5 45 OC <br />FERIv11T CONDITiONS <br />1. All calis for inspection shali be made 24 hours in advance. <br />2 All work shall be oerformed in accordance �vith the permit and current City cf Everett Desicr and Con<_truaion Slandards <br />and Specdications. i-- — <br />3 Call Location Underground Service 48 hrs before you dig TOLL FREE tQUMBER 811 i <br />5 E�stin rlcurbacul sballl t�e rOeplaced wdh � on plan) not aliowed -- ---- <br />9 ��.r � , ll �.� <br />9 urb, gutter, and sidewalk // ' <br />n Per approved plans / <br />i Call your Insr;ector Cliff Llndman at 425•339-74Cn prior to starting work � <br />, <br />( %1'w�c �i G� �� cc� w$' <br />I° u> ��, wt � w,�ru,) <br />_, <br />I G., � <br />�� <br />� � ' <br />� M <br />I r+" <br />� O <br />I O <br />vF'. ' <br />O <br />ACiWON'LLUGI'I.SFDJT Of CCNDITION� <br />l h' ur,deisi ,ned Uwner/aPplicanl hereby ug�ees to hold and <br />. ;avc harmie;s the Cily of Everetl (rom any and all daims far <br />---'- -- damages, cosls, expen,es, or causes of action thal may ansc <br />� because of installation and mainlenance of ihe improvon'�enl <br />� '--�� �/�'�' '/ �-.� <br />or olher righPobway use herelo applied for and furiher -�nrces <br />to remove same upon notice (wm the City and ta repla,.� � <br />Approved (or Construchon Date public property damaged Ihereby. <br />�_/�/ �-G'�� � `i'%i/IN� z % ��i1 � - �' /. �_ <br />,FiN'1CC INSPE 1ION Date V� <br />�3'�-S Si nalure of Applicanl Date <br />Approved as Construcled �� � <br />V;ORK AUTHORIiFD OY THIS PERFIIT h1U5T �E STARTED FJITt11N id0 DAYS OF DATF PER11R IS 1SSi�fi ?� U I� ( K� ''F 2IS 70.iF D'LICfiJiL1' <br />PURSUH� i0 COt11�LEllON. THIS PERhff� I�1�AY 6E CANCELLED Bl' THE CIIY UPON ANV STOPVAGE OF �.Ow� U�.� 1 i iS F' � LC I OVEi: ;J J YS Cl'Ml:l%'�. <br />