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�.� <br /> Date a�oe�wo,k:r�,m�i. <br />� 81ag.Deo�.� <br /> . qpplicalion For <br /> PUBLIC VVORKS PE�iMIT P'�eTc�Waes�Fee S - <br /> Less�•oul Fee Paia S <br /> II 9alanee Oue S — � <br /> Print or TyFe Only � <br /> I Plan Check No: C 45039 SEPA <br /> Applicat.Date: 07/26/94 � <br /> Job Address: 10427 lOTH DR SE phonr. <br /> Owner Owner: KELSCH JAMES A <br /> Tenznt: <br /> Proposed Use: SINGLE FAMILY RESIDENCE <br /> . Desc. of Work: -- — <br /> qpplicant FAMILY�BEDROOM�BATH ADDITION Ph�ne <br /> OFFICE SET JOB SET _ <br /> Describe Proposed Work _ <br /> APPROVED FOR PERMIT: DATE_/_/_ BY ___ ._ <br /> ---'--------'-"'—'—'--- � <br /> Prolecl Address Uf known! ------------'� —� � <br /> � <br /> Altach four(41 coPies o� Plans toi UroP��z���'''�"� � Drev: to >r.,ii.a a:�:� ncte tna 'O�luwiny as appfic26�e: � <br /> • Propeiiy Lines • C�dnterline nl sireet <br /> � • Outline ano dimenslons ef all exlsting and • Indicab: Norih <br /> propOsed struct�res On Ihe lut • �how any r,roPosed gradiny changes <br /> • Existing and proposed utilities • Show measurements /� <br /> W <br /> DO NOT WRITE fiELOW THIS LINE o <br /> PERMIT CONDITIONS � <br /> 1.All calls for inspection shall be made 24 hrs.in advance•phone 259•8810. <br /> 2.All work shall be performed in accordance wilh this permit and current City of Everett Design and Construction <br /> Standards and Specificalions. � <br /> 3.Call Locatior Urderground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-500-424-5555. <br /> \/ <br /> PUBNO�E'�UIREp MIT � <br /> �,v i , � � <br /> C�AT�� C� <br /> � <br /> � <br /> ACKNOWLEDGEMENT OF CONDITIONS <br />� ThN�.:ndersi�ned ownedapphc2nt heryby agrees lo ho�d and sav°harm- <br /> —'---'-� iess ;he Gty ot Everett irom any and ali claims for damages. costs. I <br /> ; expenses. o� causes ol ac�ion that may aris= because ol ins�allation <br /> � � -�- antl mamlenance o! the improvement or other right-ot-way use hereto <br /> iappi:ed br and �urther a9rees to rr.move same upon nolice ��om the � <br /> Approved lor ConsVuction Dale � �,;y y;d to replace public property uamaged thereby. <br /> I <br /> FINAL INSPECTION �71e Date <br /> Approved as Constructed Signature of Applicanl <br /> WORK AUTHORI2ED BY �HIS PERMIT MUST BE STARTED WITHIP7 <br /> PUBLICWORKSDEPARTMENT 780 DAYS OF DATF i'ERMI'f IS I,�iSUED AND Tl1EREAFTER IS TC7 <br /> �����`� 9200CedarStreel BE DIUGENTLY ?URSUED TO COMPLETION.THIS PERMIT MAY BE: <br /> � Everelt,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON TNIS <br /> .,.._. �cn.Qe�n nnn icr r rnrea on noVC Il11RA71ON. <br />