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w � j ..e.iS`1�{ <br /> �'^��l•N � <br /> Y <br /> � <br /> ' ' _y ,.> � �..- <br /> ; <br /> . � �+ .. �8te �����pl � �Publ¢WorFs Parmn r __ i ..• <br /> � ��h� 91/26612 I <br /> Application For Bmo�Deai.s <br /> � PUBLIC WORKS PERMIT PuUncWo�ksFea <br /> �� iotal Fee s _ <br /> LnsS Aoo�Feo 7eitl S <br /> . ��� BalTnca Doe S <br /> Print or Type Only <br /> ; �� ��� R. J. Oliver 1402 - 48th St SW Everett 98203 258-1999 <br /> Q b Owner Mailing Address City Zip Phone <br /> . .^� . Ovmer .. <br /> ��,�� ppplicant MailingAddress Cily Zip Phone <br /> � Oescribe Proposed Work Dinin4 room & Deck addition to SFR <br /> �� <br /> �� W <br /> � r~ - Prolec�AddreSs(il known) 1402 — 46th Si SW � <br /> Attach four(4)copies of plans lor proposed work- Draw to scale and note the following as applicable: � . <br /> • Properry Lines • Centedine of sireet � <br /> • Outline and dimensions of all existing and • Intlicate North . <br /> proposed structures on the lot • Show any proposed grading changes . <br /> _ • Existing and proposed utilities • Show measuremenis /� � <br /> W <br /> � � � . DO NOT WRITE BELOW THIS LINE O <br /> `� PERMIT CONDITIONS <br /> 1.All calls for inspection shall be made 24 hrs.in advance-phone 2b8-8810. � <br /> �C�i 2.All work shall be pedormed in accordance with this permit and current City of Eveiett Design and Construc�ion '��. <br /> � Standards and Specifications. <br /> ��. 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•8�424-5555. � . <br /> � I <br /> � � � <br /> �'��- ��� ��,.�� �� .��_ � �i <br /> '� �� 3.. i5�--9 / ♦�A � <br /> �+ ' <br /> I�� � 1��' O <br /> � �� <br /> a <br /> � �-�_, <br /> ACKNON'LEDGEMENT OF CONDITIONS <br /> : The undersi�nr.d owner/applicant hereby agrees to hold and save harm- <br /> '�� less the Ciry ol Everett irom any and all claims for dama9es, cosls, <br /> expenses. or causes ot action Ihat may arise because ot installation <br /> and mainten2nce of the improvemenl or other ri�hPoFway use hereto , <br /> _. applied for and lurther a�rees to remove same upon notice Irom ihe <br /> Approved for Construction Date City and lo rep�ace publi::property damaged thereby. <br /> FINAL WSPECTION Date '� <br /> Approved as Constructed Signature of Applicant Date i <br /> WORK AUTHURIZED BY THIS PERMIT MUST BE STARTED WITHIM <br /> everett PUBLIC WORKS DEPARTMENT �g0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO I <br /> � 3200CedarSireet BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Everetl,WA 96201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259�8810 PROJECT OVER 90 DAYS DURATION. <br /> I ', , <br />