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Date 11-20-91 �� �•,.,...�..�,�,��. _ <br /> Applir.ation for �',:;; o�'n� ,�1/2B17.0 --. <br /> PUBLIC WORKS PERIVEIT �°�ro,.F�;,F�° 5 _ <br /> l<ss�oo�Fee aa�� 5 <br /> BawncnD�n 5 <br /> Print or Type Only <br /> ���y <br /> [� H GERALD F.IaRLCR 3106 SHORE AVE EVERETT 98203 353-8173 <br /> 9 H tA Owner Mail�ny Aadress City Zip Phone <br /> � <br /> K� n OWNER _ <br /> O S O Appliwnt Mailing Address Cily Zip Nhone <br /> �VJH <br /> � .y� Describe Proposed Work DETACHED GARAGE <br /> [�7 O <br /> HC <br /> OH <br /> � �g <br /> N" " W <br /> ,�,� y � Project Address�il known� 3106 SHORE AVE � <br /> � <br /> �y y y Attaeh lour(4)copies ol plans br proUosed work� Draw to scnle and nole the lollowing as appliwUle: � <br /> nb y • Properry Lines • Ccnledine ol street /^ <br /> �C � • Outline and dimens�ons of all eaisting and • Intlicale Norih V� <br /> C+1 pmpOsed Siructures on Ihe lot • Show any proposed 9rading changes <br /> y O y • [xistin� antl proposed utilihes • Show measuremenls Y <br /> iii <br /> � DO NOT WFITE BELOW THIS LW[ O <br /> PERMIT CONDITIONS <br /> t.All calls lor inspection shall be made 24 hrs.in advance-phone 259•8810. � <br /> 2 NI work shall be pedormed in accordance with ihis permit and current Cily of Everetl Design and ConSimclion <br /> � Standards and Specilications. <br /> � �=' 3.Call Location Underground Service 40 hrs.belore you tlig.TOLL FREE NUMBER 1•S00•424-5555. � <br /> O <br /> i �i�l'e_- CUc'z/='- /-1..��-f �[��/:.t�ee:t,.c� � <br /> �� <br /> ��' � <br /> i� s� r/ O <br /> �� <br /> �- <br /> a <br /> __ <br /> ACKNO\VLEDGEI!�ENT OF CONDITIONS <br /> ���� The untlersi9ned oe:ner/apphc�nl nriebya9rocs to hold antl save harm- <br /> less ihe City ol Everelt Irom any and all claims lor damac�es, costs <br /> � e�penses, or causes ol aclion Ihat may a�ise because ol installat�on <br /> . and main�enance of ihe improvumrnt or oiher n9hFobway use harcin <br /> ❑pptied for and Iwlher a9�ees Io mmove snme upon nohre liom th�, <br /> Appmved lor Construetbn Date Gity anA to replace pubhc propei;y Aamn9etl ihereby. <br /> FINAL INSPECTION Datc - <br /> ApProved as Constructetl Sign�twe ot nnC��cant Daie <br /> �Ir6/ PUBLICWORKS�EPAR7�dENT 1NORK AUTHORIZEO B\' THIS FEFWIT AtUST BE STAR7ED WITHIN <br /> � 3200CetlarSLcet 100 DAYS OF DATE PERM1IIT IS ISSUED AND THEFEAF7ER IS 70 <br /> Everetl,WA 98�J1 BE OILIGLNTLY PURSUED TO COAIPLE710N. THIS PERM1IIT A1Av CdE <br /> Phone:259�8810 CANCELLED BV THE CITV UPON APJY STOPPAGE OF WORK ON TIIIS <br /> PHOJ[CT OVER 90 DAYS DUFAiION. / <br />