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, � <br /> . � � <br /> "`� ' '��eucwa�wsre�mn• �I <br /> Date_.� aiaa.000��• — ' <br /> qpplication Por � <br /> P E R M I T P�eiic Wor�f Fae S <br /> pUBUC WORKS �°�.�F°° <br /> Les��oo<<cera�a 5�� � <br /> Baiancenue 5 <br /> ��� <br /> Print or Type OnIY I <br /> 1p�x Plan Check No: B 37444 SEPA . <br /> ��y Applicat.Date: 07/20/92 � <br /> Job Addresy: 2710 VICTOA PL Z.p Phone ' <br /> � �— Owner: LAMBERT, RON <br /> Owner Tenant: <br /> K n Propoaed Use: SINGLE FAMILY RESIDENCE i <br /> H� Deac. of Work: <br /> O� H O� HOUSE ADDITION ZiP Phone <br /> yF.y ApplicaN <br /> .��. 03 OFFICE SET __J�B SET�_— <br /> �j �z� <br /> y q Describe Proposed Vv pppROVED FOR PEEUIIT: DATE_/_I_ B <br /> � �� �� I <br /> �" � �` I <br /> zy� 1� � <br /> z <br /> ~y Prolect Address�il known) <br /> S `� � � <br /> H � <br /> O l7� Atlac�lour(d)�opies of plans br proposed work-Draw lo scale antl note ihe lollowing ns apPhca e: <br /> � �r • CeNedine ot street <br /> • Property Lines • Indicale No��h <br /> Z y y • Outline and dimensions o�all esisting and � Show any proposed 9�ading changes <br /> y p y pwposed structures on the lot � Show measurements M <br /> • Exisling and proposed ulilities W I <br /> DO`10T WRITE BELOW THIS L�NE O <br /> PERMITCONDITIONS � � <br /> 1,All calls lor inspecllon shnll be made 24 hrs.in advance-phone 259•8810. <br /> 2.All work shall be pedormed in acwrdance with Ihis permit and current City ol Everett Design and Construction <br /> Standards and Specilicalions. � <br /> "' s, 3.Call Location Underground Servica 48 hra belore you dig.TOLL FREE NUMBER 1•800•424-5555. <br /> ' � O <br /> �i � ,.i . . . , . . <br /> _ w.� " �,:c', , <br /> {�' i t,��cC . , _ f _ � <br /> w„ _, . <br /> , , <br /> � <br /> . „' O <br /> �,- -�, a <br /> ��_ , I ACKNO�'�'LEDGEMENT OF CONDITIONS I <br /> The undersigned owner/app�ica��hereby agroes to hold and save harm� <br /> less Ihe Cily ol Eveietl trom any and all claims lor damages, costs, <br /> ' s <br /> expeuses, or causes ol actio� ihat may arise because of inslallation i <br /> �^+'` and maintenance ol lhe improvement or olher right�o4way use herelo <br /> appiind �or and �unher agrees b remove same upon notice Irom the �, <br /> ApProved�or Con,truction Date C�ty and to replace public properry damagetl thereby. ' <br /> FINAI INSPECTION Date Datc <br /> Siqnalure ol APPlicant <br /> qpproved as Consiructed WORK AU7HORIZED BY THIS PEFMIT MUST BE STARTED WITHIN <br /> PUBLICWOPKSDEPAR7MENT 180 DAVS OF DATE PERMIT IS IS3UED AND THEFEAFTER IS TO <br /> 3200CetlarStrccl BE DIIIGENTLY PURSUED TO COh1'LETION.THIS PERh11T h1AY BE <br /> a Evert.LH'A98201 CANCEILED BY THE CITY UPON AN"STOPPAGE OF W�RK ON THIS <br /> Phone:259�BB10 PR0.IECT OVER 90 DAYS DUA�T�ON. <br />