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.-- .-.r-_� _.__�__. _._____-- <br /> ----_T ..�____. ____�_ <br /> _.. _. :: ._ . . . . . : . . ... .. _._.. .... _,..,_.._..�.Y..—,�.-.�..-�� <br /> PUBLlC WORKS Datc ICJ����� <br /> /Public Works Pcrtnit a <br /> PERM1T puiltlingPcrm. a <br /> PUDLIC WORKS DEPARTMENT Planning Referencc a <br /> 3200 Codar Strcet <br /> Everen,WA 98201 Public Works Fee S <br /> (425)257-BB10 <br /> Gua�amee 5 /�/,� <br /> OWNER NAME : 4�,�� A�JL•- ��PUCANT NAME <br /> ANDADDRES�r•.I1,1 � ANDADDR@55�. <br /> PHONE � ;i; ' J� 7 ^ �{ � 3.L PHONE ��� <br /> TA%PARCEUD.n PROJGCT ADDR[SS'. /�/O �H l ✓� <br /> DESCRIPiIONOF O�� St��r' u�jC Q � �J- .�y� �,y � /� J <br /> PROP L�WORN. /� f�Y7.��/r�L� RF�SI/ /G/I�/I�1' r�I'^��n. �i <br /> .�at� �srs P ,?jT,y�.Y.t�3 E,9:>I- l�,(io�9, •• <br /> PERMIT CONDITIONS <br /> 1. All calls lor inspeclion shall be made 24 hours in advance - phone(425)257-8810 <br /> 2. All work shall be performed in acrordance wiih Ihis permit and current Cily ol Evere�l Design and Consiruclion <br /> Standards and Specilications. <br /> /1�/,�� Call Locahon Underground Service 48 hrs. belore you dig. TOLL FREE NUMHER 1-800-424-5555 <br /> y, 7Y.��ir,� Coi>trt^/�i�5 -{�cr Wvr� si¢c. W <br /> 3, � No �rk�i� �S�i�rf' � l5/O+��/r�r�� ����zyf�:>r ir� (f) <br /> A��U,�r�Gf . <br /> `, T�a F/���ys, m <br /> � r i �' , 0 <br /> 7 I h/G WRO,- 7 ��� Nr .��iv� 5� /.Zs OI" ��- � � <br /> � -� cr�8/a�l� a;,e .� <br /> t����i C� ��t t�t��diPs. J � Z <br /> Br Gar��)r� blrC,� Pr;:��'s�i^IAN :rtlrs�, 1�,�i� f�r�lJ:.lfip�,5 1c,^P�'�/Nstrt?r7 .SYIT/' O <br /> l � <br /> � <br /> � I <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> , <br /> z The underslgned owned:ipplicant heieby agrces to hold and <br /> a�� save harmless the Ci,y ol�verett irom any and all claims for <br /> nn�ovea or Construc�ion Date damages,msis,ezpenses,or causes ol action thai may adse <br /> because ot installation and maintenance o�ihe im�irovemen�cr <br /> other righbobw3y use hereto spplied lor anC furthei agrees to <br /> .remove same upon notiCe�rom the City and to replace pu6lic <br /> FINAL�NSPECTION ��� pro rty damaged iherqby' ! � <br /> Appmvetl as Constmcted Date . �� <br /> ! � � ��/, ' (.� ,. �,_� ���1� ��i Z <br /> ���� SignalureolAppl� 1 Dal � <br /> `` � �-. .._� <br /> WORK AUTHORIZED ov TMIS PERMIT MUST BE STARTED WI7HIN 180 DAYS OF DATE PERMIT IS ISSUED AND 7REf7EAFTER IS TO BE OILIGENttY PURSUED <br /> W COMPLETION.THIS PERMIT MAV BE CANCELLED�Y THE CITY UPON ANY STOPPAGE OF WORK ON 7HI5 PROJECT OVER 9p DAVS DURATION. <br />