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a�o�m warv�co.��i. <br /> •i r <br /> Dale" oioo o�n� • - <br /> App�ication For <br /> PUBLIC WORKS PERMIT °"°'"'"°'"."° <br /> Totel�ee $ <br /> Lev AO�I Gee Pe�O 5— <br /> Oe�anca0oe S— <br /> �, Prinl or Type Only <br /> C�1 C��1 � i <br /> ay Plan Check No: B 37239 SEPA <br /> �O �1 x � Applicat.Date: 07/O1/92 Phone <br /> � y N � 3ob Addresa: 546 VSEW RIDGE DR � <br /> Owner <br /> Owner: FRANCIS, AOGER <br /> �„� �� Tenant: <br /> y p.� I Proposed Uae: SINGLE FAHILY RESIDENCE phone <br /> Deec. of Work: <br /> � y � qpplicanl ENCLOSE SUNDECK 5 NEW DORMER <br /> 'i1 H �4 <br /> V7 H <br /> Hx z �" ' Describe Pwposed Work OFFICE SET JOH SET <br /> [l7 y � APPROVEU FOR PERMIT: DATE_/_/__ BY <br /> � �g W <br /> H. O I "' � <br /> ZVi � <br /> y y z j Proiect Adtlress(il known) <br /> � <br /> �N y I Attach lour(4)copies ol plans tor proposed work-Draw to scale and note the lollowing as applicable: � <br /> • Cenledine ol streei <br /> � �y � • Properiy Lines • Indicate Norlh <br /> • Outline a�d dimensions ol all ezisting and � Show any p�oposed g�ading changes <br /> � � r proposed strucWres on Ihe lol • Show measurements M <br /> z y y • Exisiin9 and proposed utililies W <br /> y � � � DO NOT WRI7E BELOW THIS L�NE O <br /> �i.� <br /> f�� . PERMIT CONDITIONS ^ <br /> 1,All call,lor inspeclion shall bo made 24 hrc.in advance�phone 259•8810. <br /> 2.All work shall be pedormed in accordance wilh this permit and cwrenl Cily of Everett Design and Constructlon ♦ <br /> Slandarr�s and Specilications. � <br /> II � ' 3.Call Localion Undergwund Service 48 hrs.belore you dig.TOLL FREE NUMBER 1•800•424•5555. <br /> ��� � 7 � � <br /> i /� � . �, /, , � , <br /> /_, � <br /> i _,,;- ✓ <br /> � �� �� � <br /> � j , <br /> i--- II � <br /> -'` �. <br /> �"� I� <br /> ��� <br /> I II ACKNOWLEDG[MENi OP CONDITIONS <br /> The undersigned owner/applicant hereby agrees fo hold and save harm� <br /> less �he City of Everet� irom any and all cla�ms lor oamages, cosls, <br /> ���. � eapenses, or causes ol aclion Ihat may arise because of installation <br /> and maintenance ol the improvement or othei right�obway use hereto <br /> � applied br and Wrther agrees to remove same upon nohce ��om the <br /> Appioved for Construclion Dale Cily and to replace public properly dam.ged Ihereby. <br /> IFINAL INSPECTION Datc Date <br /> , Approved as Construcled Signature ol ApPlicanl <br /> I �I���� . WORK AUTHORIZED BY THIS PERMIT MUST �E STARTED WITHIN <br /> PUBLICWORKSDEPAR7MENT 1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200CedarSireel BE DILIG[NTLY PURSUED TO C0�1PL[TION.THIS PERMIT MAY BE <br /> Everett.WA 9d201 CANCELLED OY THE CITY UPON ANV STOPPAGE OF WORK ON THIS <br /> i Phone:25?-OB10 PROJECT OV[R 90 DAVS[7URATION. <br />