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� . _ _. _ . <br /> :J / <br /> - � <br /> � � MPlication Fw ' <br /> PUBLIC WORKS PERMIT �ta 12-08-97 <br /> PUBLJC WORKS DEPAHTMENT �� public Worka Pemifl N 388 <br /> 3200 Cedar Street w <br /> Everetl,WA 98201 259-8810 ?' <br /> � Building PertnR N 57334 <br /> TYPE OR PRINT ONLY Public Works Fee S 2��� <br /> = .j. .� c� �:> r..i �,i ir: <br /> iL M O :iJ <- �u � � d� <br /> �Y�M Ul <br /> Carol Chartier 10015 25t$�hve S+E;=iEveiett�Wa 98208 3'.6-3355 <br /> Owner Mailing Pddress City� Zip Phaie <br /> f <br /> � <br /> 1 ;_i _� <br /> �Tl�er l'l ::I' IT� lJ _ <br /> Applicant Mailing Address � -' �� '-' 'T '-' Ci ZI Phone <br /> r� '� et rr —i ' �Y P <br /> .-1 :.Y. iii (A i..i C�_ I' <br /> Describe Proposed Work convert ara e into 3 bedrooms for Adult Famil Home � <br /> � <br /> � <br /> � <br /> PROJECT ADDRESS(if known) 10015 25th Ave SE � <br /> Attach four(4)coples of pians for proposed work-Draw to scate and note the following if applicable: O <br /> •Property Lines 'Outlina and dimensions of all existing and proposed structures on the lot •Exist(ng and proposed utilNies <br /> 'Ce�tertine of street "Indicate North 5how any proposed grading changes 'Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspection shall be made 24 hours in advance- phone 259-8810. o <br /> 2.All work shall be performed in accordance with this pertnit arid current City of Everett Design and <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5665. N <br /> � ��,�u�� �' Trr,-wn��.��,/ c�rea. /�vs� 6e � <br /> �7ave� ��� �'s�iQ« os- Conc�+efe _ O <br /> a <br /> .S .Y�.nS�LL �� �P�^o�D�v�z�t �i+a�n� S'f,�s�2�n <br /> CO //ISvrL 7`Jtf �"Un•D� o�02t h0� /h� a� <br /> P <br /> r�,a h 6�r �a th e F4s f. SF_ r uP rr+ e¢f.:,� <br /> �ui�ti PuOL."c, L•Jor.Es /n SPec7�or fv o%scurS c�P�royS . <br /> ACKNOWLED(iEMENT OF CONDITIONS <br /> The undeisig�ed ownedapplicant hereby aprees to hold end eave hartnbas <br /> �� the City ot Everett hom any and all clairm for damepes,costs,expenaes,w <br /> vedJ r� siruction ete causes of action that mav arise because W instaNetbn and maintenance of <br /> the improvement a otl�er ngM-of-way use herelo applied forend f�xtMr ep�ees <br /> �� to remove same upon �oNce frum the Cfty and to replece pudb propMy <br /> �. ��w'"" .�►3�- a/ dar��d mereny. <br /> FINAL INSPECTION Date . <br /> Approved as Constructed <br /> /.1 /� ¢/� <br /> . ture of Appl t Data <br /> WORK AUTHORIZED BY THIS PERMIT MUST 8E SUIHTED WITHIN 180 DAYS OF DATE PERMR IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLEf10N.THIS PERMIT MAY BE CANCELLED BY THE GTY UPON ANY ST6PPAGE OF WORK ON THIS PROJECT OVER 80 6AYS DURAiION. <br />