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Date�'''y`� <br />Applicalion For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Plen Check No: B 36332 SEPA <br />Applicat.Detat 04 17/92 <br />� Job Addreee� 48 6 5 3RD AVE <br />Ownei: PENTZ� JOSEPH F. <br />1'ene�t: <br />Prapoe¢d tlan: SSNGLE FAMILY RESIOENCE <br />Deec. of Nork: <br />p PARTIAL FOUNDATION UNOER E%ISTING HCUSE <br />Oescri[ �FFICE SET_ JOB SET <br />APPROVEu FOA PEAMIT: UATE / / <br />Pmjea A�Aress (it knmvn) <br />o�ea won� v..�n . <br />B'W �en1 �. T�!'.�i._� <br />�,D�Kwo».... s <br />,a. �.� <br />�....��,..o.,a s <br />e.n��. oo. 3 <br />�ty 2ip C�one <br />ilY ZiP P�one <br />Allac� lom (a) copies ol0�ans lor proposed work � �raw to scale and note Ine lollowinp as apo�ica�l¢: <br />• Propetly Linen • Cen�etline ol slree� <br />• Outhne xn0 Eimensbna ol ell e•isting and • Indical• Nor1h <br />propaseA nlructures on t�e lol • Show any pmoosetl BraQinp c�anges <br />• E�Istinp and pro0o6eE ulilities • Show mexauremenle <br />PERl,'T CONOITIONS <br />1, All c�: le lor Inapection a�ell ba made 24 hn. in aCvance- p�ona 259•8810. <br />2. All r,��rk shall be pedorme0ln emorCance with thin permit and currenl Ciry o1 Everett De6ipn and Conslruc�ion <br />StanOarda enE Spetifita�ioni <br />5. Call Lxatlon UnEeryroucd Service a8 hm. belore you Oig TOLL FREE NUMBER 1-800-424•5555. <br />f" — l <br />t%,c� _ . _, . . .- �.. <br />. <br />— J <br />;.% <br />ApprOv¢0 lor COnsimttion Daie <br />FINAL INSPECTION Date <br />/ o0�oveE ee Constm[tae <br />PUBLIC WORKS �EPARTMENT <br />JY00 CeEer Slreei <br />Evoeq WR B8P01 <br />Pnone 259-BBiO <br />W <br />H <br />_/ <br />,rA <br />V+ <br />O <br />a <br />ACKNOWLE�GEMLNT OF CONOITIONS <br />T�e undersignetl owner/apPliwn� pareby agiees lo hold anE eave �a�m <br />less t�e Gly ol Everett Irom any ana mi claims br CameQ¢s, costa <br />esoanses. or causes o1 action inet mey arise oecaus¢ ol installation <br />dl1� 111dI0�POB�CB OI I112 iT0lOvlTlfll O! OI11!! lIQ1140�'Wdy USP IlplEIO <br />apPli¢G for antl I�tl�er aprees �o remove aame upon notica bom Ine <br />Clly antl lo replace Oublic property damaqeE t�ere0y. <br />SiBnaNre ol AOV��W nt Oate <br />WORN APTHORIZED BV THIS PERMIT MUST BE STAFTEO WITMIN <br />180 DAYS OF DATE PERMIT IS ISSUE� AND THEREAFTER IS i0 <br />BE DILIGENTLV PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CFNCELLE� BYTHE CITV UPON RNY STOPGACE OF WORK ON THIS <br />PROJL�T OVER 90 DAYS DURATION. <br />