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� � � , , _.� <br /> lp �U y rwi¢wo�e.sP,.�m�i. —. ...._ .--. <br /> i0�� ^ Date 8/26/9L 37811-----..__ . <br /> C N B�Uq OeU� ' <br /> Application Por <br /> � � � pUgLIC WORKS PERMIT '°°'"`"°„'"° S- - <br /> To�al Fee <br /> y O less Aod.Fcc PnN S__ <br /> O O1 <br /> �U H �V Baiance Duc 5 <br /> N N <br /> � z� � Print or Type Only <br /> � cna R Paul W Calhoun 2216 - Sth St Everett 98201 252-2596 <br /> H • Phone <br /> � y � Owner Mailin�Address �'�S' Z�P <br /> t7 ai N ,2iley Const. ��43� Old Sno–Idon Rd Snotiomis5 98290 568-1651 <br /> g j b y Maili�9 Address Cily Zip Phone <br /> Applicant <br /> � � [r-0 <br /> 0 y Describe Proposed Work Sedroom & bath addition to S <br /> W I <br /> ��1 Fi Si'h Ci' � I� <br /> Prolecl Add�ess hl known) ' <br /> � <br /> Attach four(nl copies o� Plans for proposed work� Draw to swle and note the following as applicable�, � ' <br /> • Centerline oi sireet <br /> • Property Lines • Indicate Norih <br /> • Outline and dimensions of all existin9 and � Show any proposed yrading changes <br /> proposed 5trucW res on ihe lol � Show measurements M <br /> • Ezistinc� and proposed u�iliiies W <br /> �-� �-�, DO NOT WRITE BELOW THIS LWE O <br /> � �' PERMIT CONDITIONS �y-$$1 O. � <br /> . � 1,All calls for inspection shali be made 24 hrs.in advance-phone 2•� <br /> 1 2.All work shall be pertormed in accordance wi h ihis permit anA current City of Everett Design and Construction <br /> � Standards and Specifications. � <br /> � 3.Call Location Ur.derground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800•424•5555. <br /> �' <br /> .� �<�' O <br /> , <br /> .,ti�� ��=� ���.;,,� �t <br /> i /�.���::� ��-��� : � � � � F- <br /> __ <br /> �y��� � cn <br /> __ ��� o <br /> a <br /> u ' <br /> i1�' " <br /> I i ACKNOWLEDG[MENTOFCONDITIONS <br /> �' Th:,unoersi9ned ownedapp�icant hereUy a9rees lo hold and save harm- <br /> �'`�. I�ss thr City ol Everetl irom any and all claims lor tlamages, costs, <br /> e.penses. or causes oi action ihat may arise hecause of installalion <br /> and maintenance of Ihe improvement or othe� right�ol-way use hereto <br /> applicd for and lu�ther agrees to remove same upon notice ��om the <br /> qpproved for Consiruc�ion Date (;ily and to replace puUhc p�operty dam29ed thereby. <br /> FINAL INSPECTION Date Dale <br /> App�oved as ConsUur.ted <br /> Siynature ol Apphcan� <br /> � WORK 4UTHORIZEU BY THIS PERIdIT MUST BE STARTED W�THI <br /> !��T/ PUBLIC WORKS DEPARTMENT 180 DA1'S OF DAiE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> � 3200CedarStreet BE DILIGENTLY F'URSUED TO COMPLETION. THIS PERMIT MAY BE <br /> EveretL WA 98201 CANCELL[D�V THE CIT�UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone'.z59�8810 PROJECT OVER 90 DAYS DURATION. <br />