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� � � <br /> � <br /> p � Date r„�,���•r,:��,v..,m.�. <br /> C y y Appi�.calion For eioa o<o� •� . <br /> � � � PUB!IC WORKS PERMIT Pu�ic�iee��� S <br /> 0 Q � 1e55Pp0�F!c FaiO 5 <br /> � N N Oaiance0�c 5 <br /> � � � Print ar Type Only <br /> Plan Check No: B 38176 SEPA <br /> p n � Applicat.Uate: 09�28/92 <br /> F� ta Job Address: A4 2 E XAVIER WAY <br /> Owner: WAKEFIELD WILLIAM E <br /> � y � Owner Tenant: �p Phone <br /> Proposed Use: SFR/CARPORT <br /> H Deac. of Work: <br /> y CARPORT <br /> p y Applicant P Phone <br /> � � r' OFFICE SET JOB SET <br /> � � �y Describe Proposed 1'Jork _ pppROVED FOR PERMZT: DATE BY <br /> —�—�— <br /> W <br /> Proiecl Address(i1 known) � <br /> Attach lour(a)copies of plans lor propooed work-Draw to scale and note Ihe lollowing as applicable: � <br /> • Property Lines • Centerline of street ♦^ <br /> • Outline and dimensions ol all ezisting and • Indica�e Norlh V� <br /> proposed slruclures on�he lot • Show any proposed gratling changes <br /> • Exisling and proposed u�ilitie2 • Show me25urements Y <br /> W <br /> �-� '�� DO NOT WRITE BELOW THIS LINE O <br /> � C� PERMITCONDITIONS <br /> , 1.All calls br inspection shall he made 24 hrs.in advance-phone 259•8810. � <br /> 1 2.All work shall be fedormr.d in accordance with ihis permil and current Ciry ol Everett Design and Construction <br /> Standards and Specilications. <br /> � �� 3.Call Location Underground Service 48 hrs.hefore you tlig.TOLL FREE NUMBER 1-800•424•5555. � <br /> !�� <br /> ��i�jl�<.�_ C,.�rz..f�:, /•a-:.. n�.��t %l�:r� ,<<��.cc� .� � � � <br /> �� � � <br /> � I`NITIAL IN&PECTIOK '��� <br /> KIRK BROOKS � <br /> /C��y��. � <br /> �� DATE ` ,�' l`� - <br /> , � .�, a <br /> _t-� , � ���-. , <br /> i � �''�,� �,..� <br /> � � � �� , ACKNOWLEDGEMENT OF CONDITIONS <br /> I ' The untl��signed owncr/applicant hereby a�iees to hold and save harm- <br /> � '�e� less the Ciry ol Everett irom any and ail daims lor dama9es, costs. <br /> � expenses, or causes ol ac�ion that m2y arise because ol installalion <br /> � antl mainlenance ol lhe improvement or olher righ4obway use hereto <br /> applied lar antl lurther agrees �o remove same upon notice from Ihe <br /> Approved�or Consiruc�ion Oale City.lnd to replace public property damaged ihereby. <br /> FINAL INSPECTION Date <br /> Approved as Conslructed Signature ol ApPlicant Date <br /> PUBLIC�%lO.iKSDEPARTMEN7 H'ORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 180 DAYS OF DATE PERMITISISSUED AND THEREAFTER IS TO <br /> 3200Ceaai btreet BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAV BE <br /> Everatl,WA 98207 CANCELI.ED BY TH[CITY UPON ANy STOPPAGE OF WORK ON THIS <br /> Phone:259-BB10 PROJ[C7 OV[R 90 DAYS DURATION. <br />