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�. �,_'. <br /> Y{-..., '�� <br /> r <br /> �� <br /> ..� � �r.t�,l.4� K.-C.u�` ( <br /> ' � � <br /> '. .��� .� . . . . � . . . . . . . .� � .. <br /> ��� ' � <br /> ��� „- � �-Z�,-� � <br /> Date 11 26/91 4 r�m,o xorxe�e�mu a �1 `k-- <br /> erig oao�.+ 91/z8204 <br /> p�. d Applicatlon For �i _ <br /> �� ��y[ �r RKS � �� �' y PubTotxlFaeFee <br /> ��J PUBLIC O E��6�TING '� 2 S <br /> Q�.1Y (7 "i I LeesPoO�FaePeld S <br /> '2iM� ' r� ZV� <br /> �j �� r' �� C� C� 1 . Ifi Balan<e Due S <br /> r y Print or Type Only i;=; �' � �"' � ' � � ��_ �� G � <br /> bl -� G � tr'� O .� n + .' <br /> � . .f ('J " Lfl ..�J � M �f+ ln +rF �+; <br /> � H V 1.i U: <br /> '-�� � 21902 �+8rh ave � �Y: �r e+-`„' wa 98nz6 ?56-24 .. <br /> � � F � r m �, c � .Zi .'hone <br /> Owner Mailing Addr�s c, U� ni « .. ����Y S� - °' -p I <br /> o tli c� �,� ,-� c � c� �-. �� ri c..i <br /> O 1— O �z ^� O � iii [� U? ::� 1 liJ I <br /> �� Y�i' �i r4 fIJ �r SY. �i] C�! S� �ii [� i�.' !�J <br /> --- Owner `�' <br /> ' ppplicant Mailing Address City Zip Phone <br /> Constnict new Single family residence _ � <br /> Describe Proposed Work j <br /> _ W � <br /> �3 �Prolect Address(if known) - � <br /> � <br /> Altech four(4)copies ot plans for proposed work•Draw to scale and note ihe lollowing as applicable: � i <br /> � • Property Lines • Centerline ol street . <br /> �- • Outline and dimensions of all existing and • Indicate North � <br /> + � proposed struc;ures on the lot • Show any proposed grading changes � <br /> ��� , • Ezisting and proposed utilities • Show measurements M � <br /> W � <br /> � DO NOT WRITE BELOW THIS LINE O � <br /> � i <br /> f <br /> �_ , PERMIT CONDITIONS � ' <br /> 1.All cells for inspection shall be made 24 hrs.in advance-phone 259•8810. I <br /> �1 2.All work shall be performed In eccordance with this permit and current City ot Everelt Design and Cons�mction i <br /> � � StandardsandSpecifications. � �, <br /> � I 3.Call Locatlon Underground Service 48 hrs.6efore yo�dig.TOLL FREE NUMBER 1-800-424•5555. , <br /> , i , 4 lnst�al l. rocl:. cons�tr�.�r_tton �n7-.i�.-�nre hr_17i.nd drivewav ,vs u� r �; tv O ',: <br /> �s stand� rri 4t2ii8 and ernsion ron!-rel �s dir-�cte�i b�/ F�,iblic ��1�_�r4�.� <br /> ,I InsP�'� tni�. �i <br /> 5 p.:eep nti si.re -�. I , �-1� �n ai� �11 ti.�nrs � <br /> �� 6 f;url� ��.�hi�r .+nd sidPw:�ll<. in ihe pl it ar� new anci i.indamancd . ! <br /> �1 � any J�m-.�qe i�hEreto sl��l .l. bc. repla�Pd a1_ thF. disrr-etion of the � �. <br /> •i Fiibli.r Wnrks Ir� spe�=ioi'" • <br /> "7 Aiii r_hinae� in t.he dr:ivea�a� c�rt m�.� _t ba npPro�•F�h 6y the ��l�l_ic- O . <br /> i ,�� Wc�i 1:.= Inspeci or��. <br /> ���� - 8 Ac1)u=_i' i���rer l��:E.s �.o r7rad� -�i: =°�-i n- r-r,n-tructi.on . � '. <br /> � 9. Driv:-�wa/= sh �l7 Y_�r- cnmf-�lr=tr. d � ontad b��Pr�rc dri ��; r�r� rn-i ih- r,�. �� <br /> I <br /> 1�� ! <br /> ,. � ACY.NOWLEDGEMENT OF CONDITIONS i <br /> The undersigned owner/applicant hereby agrees to hold and save harm� � <br /> _ less Ihe Ciry ol Everet� irom any and all claims for damages, costs. � <br /> -� expenses, or causes ol action that may arise because of installation ; <br /> (� � and maintenance of ihe improvement or other righ4of•way use hereto � <br /> - L���\ �'�� �-t,� �1-�- -� - ���1 applied� or antl further agrees to remove same upon notice irom the , <br /> Approved for Co�sir ction ���� Ciry a � to replace public pruperty dama9ed thereby. <br /> ��-��� �-•� 1-%'Z � � 1.��10�9 � �� <br /> FINAL INSPECTION Date Date <br /> Approved as Constructed Si ol Applicant . <br /> W R A HORIT_ED BY THIS PERMIT MUST BE STARTED WITHIN .� <br /> �Ar� PUBLICWORKSDEPHFTMENT 180 D YS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO . <br /> 3200 Cedar Street BE DILIGE�vTLY ?URSUED TO COMPLETION.THIS PEFMI7 MAY BE � <br /> EveretC WA 98207 CANCELLED BY iHE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259-8870 PROlECT OVER 30 DAYS DURATION. / <br /> J <br /> I <br /> � <br />