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Date 6-28-94 �?`J�1��1+�7 �—�,U-9G ,�"i �� !/ I J' <br />Applicalion For <br />PUBLIC WORKS <br />Print or Type Only <br />N <br />PERMIT� <br />� <br />r <br />N <br />M <br />d <br />Fairmont Homes 21�U2 38th Ave W Brier 980: <br />Owner <br />Applicant <br />Describe Proposrd Work <br />i�^a�:in�, 4�:tlress <br />r.�.,�o�u: nddn�ss <br />Adult boarding home <br />Cdv <br />8 O O <br />M N M <br />� `V "n/�97^ J r ..Ln� �r� . _ __ __._-- <br />------ ---- - - - <br />Frolecl Address hl known! _ Bldg C_ <br />Pubhc 1YO��5 Vnrmil � ���oO I / <br />a�n� o�o� • 44776 _ _ <br />F�,�i��,�,v�,�,� , s <br />iOtal FrC <br />�1ief5�51 4001 frn Par1 S <br />R'�4�5`rP Cu�. S <br />� • w <br />iP '—_'_ Phonn —_— <br />AttaCh four (4) eopies cf Plans loi n:oP���d wo�n � Diav: to ,eal...�:n nr.n� ;he'o�lv.ti�iny as anUlicahh•. <br />• Proper!y LineS � Cent��rlinr nf 5treei <br />• Omhne anA dimensions ol ali ea�stm9 and • Icdicate Norih <br />proposed slruCtures on the �N • Show any r.r000setl ��ratlinn rhan;)�•s <br />• Existing and proposed utild�es • Show measu�e�nents <br />fiELON' <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in advance - phone 259•8810, <br />2. A�I work shall be pedormed in accordance with lhis permit and current Ciry ol Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. betore you dig. TOLL FREE NUMBER 7-800•424•5555. <br />�• �s p� PI� �� �s�y�- <br />S�}-ov;�e earcm� �--- -�e,--;� yrr� �e�rc�l �� A;a et O <br />W <br />� <br />�w <br />_ / <br />� <br />� <br />� <br />� <br />� <br />a <br />ACKN06'JLEDGCh4ENT OF CONDITIONS <br />Th✓ u�,dnr�iqneA owner/apphcant hercbY a�rees to hold antl sacC harm� <br />i��ss Iha C�ly o� Everelt irom any antl all claims tor damanes. costs <br />enses. o� causes ot actron thal may arise beC2u5e ol installahcn <br />maintenance nl tl��• imProvement or oiher nghhoFwaY use heielo <br />i��eG for and �urth�,r agrees to remove samc upon noi�ce Irom Ihe <br />�,ind In iepLtca U�i� lic prooerty damag¢d thereby. <br />Approved as Constructed <br />�_� PUBLIC WORKS DEPARTMENT <br />'r��{—�— 3200CedarStreet <br />���� Everett, WA 98207 <br />Phone:259�8810 <br />Si9naiurc ol ApPlican! Date <br />lh'ORK AU7HORIZFD BY THIS PE iM1T MUST BE STARTED WITHIN <br />7H0 DAVS OF DAT[ PEFAUT IS ISSUED AND THEREAFTER IS TO <br />BE DILIG6NTL1' PURSUE� TO COMPLETION. THIS PERMIT MAY BE <br />C.Fl^JCELLtD BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PRO.IECT OVER 90 DAYS DURATION. <br />