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, <br /> �� � <br /> m � x <br /> 9HCA <br /> 4 <br /> y� t��+ <br /> �i1 N KJ . . . � P�e���wm.sr.-.�n. <br /> y rn F+ Date t. e.:u o.�� . <br /> �O � Applicalion For <br /> Vueec waas Fea <br /> y " PUBLIC WORKS PERMIT To�eiFee g <br /> O N �assnno�Fee aa�a 5 <br /> �� � Baia�co o�c 5 <br /> x y� Print or Type Only <br /> z <br /> H H SEPA <br /> �y y Plan Check No: 8 37113 <br /> O H Applicat.Date: 0 6/2 3/9 2 pi�one <br /> O C[o _--� Job Addreee: 25 b2 VICTOR PLACE ZiP . <br /> G C � Owner Owner: JUSTICE� GWEN <br /> � t�� Tenant: <br /> i <br /> y y y Proposed Use: CARPORT phonc <br /> y p y Desc. of Work: Z�P <br /> qpp�— icanj CARPORT G DRIVEWAY <br /> D^scribe Pwposed W <br /> OFFICE SET JOB SET <br /> APPROVED FOA PERMIT: DATE_/__I__ BY <br /> �� <br /> �— � <br /> Project Address(il knownl � II <br /> Altach four(4)copies ol PI ms lor proposed work�Draw to scale and oo�e�Cenlle line o�stree�`a61e: � <br /> • Property Line� • Indicale North <br /> • Outline and di.nensions ol all existing and � ghow iny pwposed gmding changes <br /> proposed stmc�ares on lhe lol � Show measuremants M <br /> f�� • Exisling and D�oposed utilities ��� <br /> � ' DO NOT WRITE BELO�'�'THIS LINE O <br /> PERMIT CONDITIONS � <br /> '�1 i.All calls for�nspection shall he n'ade 24 hrs.in adva�ce-phone 259•8810. <br /> 2.All work shall be pedormed in acc�rdance with Ihis permit and current Ciry ol Evere�t Design and Construction <br /> tO Sta�dards and Specilicaliona � <br /> � 3.Call Location Underground Service 48 nio.'r^��re you dig.TOLL FREE NUMBER 1•800•424•5555. <br /> r'f 0 <br /> ��.� , .j� �i— �lc�,•✓��� ��.,_. _7� r� � : [.; _ ��/� <br /> " � ,S� h�a.f=, ; i <br /> � � ' ..l' .,� ur� a�Z� �c� , .�-� � ' \I♦ <br /> � ._;�-,.,ccGa � . . . <br /> � , �� �.�� �:��,�v ��,�:�t�._,�r,. � � <br /> � �� /J �/ t�t.s. <br /> �' c . � ..,_ �.v an�---r-c1 ��nr.c p . <br /> � <<���, a <br /> � � <br /> ,. ;, , , <br /> ��s � . , � : �,�. �;,- , <br /> �, , 7 ,-.� «�:- - ,- , ., . . <br /> _� . �,,/ . , �; . <br /> ; � <br /> � ACKNOWLEDGEMENT OF CONDITIONS <br /> . ���� The undersigned owner/app�kanl hereby agrees to hold�nd save harm� <br /> � less the City o� Everetl Irom any and all claims for damae�es, costs. <br /> expenses, o� causes ol aclio� Ihal may arise because of installalion <br /> and maintenance ol Ihe improvement o�other righPol-way use hereto <br /> Ap?roved br Construction <br /> Dalc <br /> GP9land�o eplace,public�p�ropertyrdamaged herebyn ���ice Iwm Ihe <br /> Date Datc <br /> FINAL INSPEC710N Signalurc of Appiicant <br /> ApprovedasConstructed WORK AUTHOF7IZED BY THIS PERA"IT MUST BE STAFTED WITHIN <br /> IA��E� PUBLICWORKSDEPARTMEN7 180 DAYS OF DATE PERMIT IS ISSUED AND THEFE�FTER IS TO <br /> 3200CedarSlreet BE DILIG°NTLY PURSUED TO COMPLETION.TNJS 'EFMIT MAY �[ <br /> � Everelt.W�98201 CANCELLEC BY THE CITV UPON ANY STOPPAGE OF WORK ON THIS <br /> � Phone-.259�0810 PROJEGT O\'ER 90 DAYS DURAiION. <br />