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_ � <br /> r <br /> � <br /> '� <br /> r <br /> `"°rc" APPLICATION FOR PUBLIC WORKS PERMIT <br /> � TYPe or Prinl clo�tlY with ink <br /> PRESS hARD•YOU ARE MAKIN6 COPIES pERM1T NO. �z ��� <br /> PUBLIC WORKS <br /> '. EVERETT,WASHINGTON BLDG. DEPT. NO. e� <br /> ❑ OWNER 6d AGENT DATE 11ug_78,. 798Z_-_ + <br /> APPLICANT/FIRM REPRESENTED . SIDTK7ND$_DF5IGN_ IIUILDII2$____ __. . _._--._—-_ <br /> ADDRESS __ 9725 SG 36, Suite 214 CITY Mercer Island TELEPHONE Z36-O800 <br /> HEREBY APPLIES FOR PERMISSION TO use sidewalk area around building foc erecting scaffolding <br /> to facilitate cleaning exterior of lwilding at the following location: 3025 Rucker Ave. <br /> LVerett, WA. � <br /> AT THE FOLLOWING LOCATION - - <br /> Attach five(5)copies of preliminary plans for proposed work.Draw to scale and show the f��lowing as applicable: <br /> ' Property Iines and street identity. ' Topographic changes requiring cuts and fflis <br /> • Outline and dimensions of existing and other than normal foundation. <br /> proposed structures. ' On•site drainage systems when required. <br /> ' Existing and proposed utilities. ` Erosion control methods when required. <br /> • Centerline of abutting right of way. • North arr� <br /> ���' � <br /> siqn. of AOPlicenl <br /> coNoirioNs: PUBLIC WORKS PERMIT <br /> � � ����r � c-�� - ��1 �� <br /> �; �i � j <br /> f>/ LC; <br /> u.l Y � � <br /> J <br /> , � <br /> � G 1 ;_ V-�-1 ` � <br /> Q � � �.i � j1� ; I <br /> A 3�z, R��cKFr A�-� T 1 �., � , L. : <br /> °� s � _ � , � � <br /> � <br /> y � � � i � : � <br /> � iy �_: . <br /> � ' <br /> � 1. . <br /> ^ "�1bEK/A�K <br /> Tne uneers�gnee owner neree� a^.:ees to nold ene saw narmisw <br /> ine Cuy ol Everett imm eay ena en cieima for tl�m�peR co�t4 <br /> erpenses,or ceuses ol ection inat m�y eriae bsuuw W������utbn <br /> P/�I FI� A�/E '---� ane me�ntenence oi I�e Improvement or other rioh��ol�w�y w� <br /> hemto applieE lor anG furiher epreee to remove ume upon nolka <br /> Imm Ihe City antl to replace D�Dllc property Cem�Ob ��areDy. <br /> il'�,.� "`� Y>-I�: `;Z S�M�n�aD� `Drsic•n, .�u���e=� <br /> L APPRO ED CONSTRUCTION D TE ACK!NOWLED EMENTOFC NDITI NS � <br /> S(�J C.� // /" � � L� � <br /> ? VED AS CO RUCTE �TE � SGNAT R OF APP D E <br /> PERMIT IS VALID FOR-.� CALL FOR INSPECTION <br /> ��,��� POST ON 259•8811 <br /> EXPIRATION �'� F•�- JOBSITE 24HRS.BEFORECONSTRUCTION � <br /> L <br /> J <br />