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i <br /> � - p �f.i � �c ( �Ilt� ��Mi� ��` � <br /> Date��--7 /d � ,�,, w„„�•..,.,,. — ��`J-1_ _ <br /> , -- t� <br /> //��/k, Iuug0e�1 � — __. ..—'"'._"_ <br /> . ,1Pnl�cat�nn fni <br /> PUBLIC WORKS PERMIT �'°°��w°,�.�°° <br /> io�rlfnn S --.___ <br /> i nts nnnl fnn Pa��l S— <br /> �„�.� „��„� : 2Q- <br /> Pnnt or Type Only — — <br /> 3y2 -6yy6 w <br /> 1%4u,�, G�IICj�e � 5��� l�'" �L SE Ei�� �- 9D'7d� 3`l$ -6�a3N <br /> Ownei Maihng Atldress Cdy Lp Phone <br /> �Ql: lt �/} �7d1/`� _. _ __—_ <br /> ------nppl�r.en1 Maili�9AdA�css Cnv Zin Pl�one <br /> [)��;r,rihe ProP�sed WorF _ �9�-_J�.J.p_—�JS]L��-[1"'� �V4JY_`._.���._�,/ 4('�1Z�[rQy��'J___ <br /> / ~ <br /> __ __ _"__",_ _ __._ <br /> - r �� �] ^ �y- ----- - - - W <br /> I'�<i�r•fl Addressl�� knownl J�.$—�� �� �� �--y=";�--�-�--���-dV �� � <br /> Attach loui 1�I ��V�as o� p�an5lor proposed wmk � D��w In scale� and nule�he lullowmg as apphceble �� <br /> • Propeily L�nes • G��nterlm� of 51rp�•t /A <br /> • Oulhne enA Aimonsions nl all cawbnq anq • Ind�ra�e Nor�h V� <br /> proPosed 5lrudures on Ihn lot • SI�oW any propotir•J�!radinp rh;�n��r�s <br /> � • Ex�sling and p�onosed uliLl�t�s • Show meas�uein���its � <br /> DO NO7 WRIIE: BEIOW THIS L�NF. O <br /> PFRMIi CON�ITIONS <br /> 1.All calls lor Inspec�ion shpll be mede 24 hrs.in ativenr.e� phone 259-B8I O � <br /> 2.All woik shell 6e perlormed m eccerdence with this permil and current Cily ol Everetl Desu�n a��d Constiuction <br /> Stendards and Specil�cetlons. <br /> 3.Gall Localion Under�row�d Service 4B hrs.belore you Aui TOLL FREE NUMBER 1•8�0•4'l4•5555. � <br /> �• IIJ:�I�Tlca'J CEQ� � rc e O roc' ('��. �-�Acc]� �� rZC�U c_ � � <br /> ���-1 01/(Ni/9] .�21FM OQOAN;154 � t_1 <br /> �� / �. Y/ II <br /> � <.���t_ �//'� � C �'R_a-I B�S l OJ \�I I'77 � 1�)C kam�d0�K. <br /> nFr.�o +20.00 <br /> <,�tm�.,�- cr+FCF; s^o.� O � <br /> a <br /> ACKNOWLEUG[MCNT OF CONDffIONS <br /> .-�� The undersigneA owneiinpplir,anl hereby nyrr.es Iq holA nntl 5ave hnrm- <br /> ��r ----- <br /> — less the Gly ol Everell Irom nny and all claims lor Aamages, costs. <br /> - �L:L ��� eMpenses or causes o� nr.lion Ihal m�y nrise hnr.ause ol inslalla�ion <br /> ���7 and mainlenTntr ol Ihe improven.enl or olher nqht-nbwny use� hFrPlo <br /> __ __—�`� ����- apl'1���d �or qnd lurihei agrees In remOve Same upon nohrF huin Iht� <br /> Approved� stru/rt�l�� ` . . � > �t�' City Hnd to replate pUhhc Pro er�Y damqyeA Ihereby <br /> - - �� 1�/ / __ � � p� ,�1.�.- _ ����--�'y-=�j-! - <br /> ��N�� �N _ T��14 <br /> llppiOVYd�5 COl15�ilICIP.A Siynatwe cl APPI an� ���" <br /> WORK AUTHURIZED BY iHIS PERMIT MUS1 BE SIARTCD WITHIN <br /> �.��.��.�� PUBLICWOPKSDF.PARTMENT 180 DAVS OF DATE PERMR IS ISSUCD AND THEREAFTER IS T�� I <br /> � 3200GederStreel BE DILIGENiLV PURSUED iOCOMPLETION THIS PEHMIT MAV BE <br /> [vrrelL WA 98201 CANCELLED BV THE CITV UPON ANY STOPPAGE OF WORK ON THIS <br /> 1'������e 759�flP1n PflOJfCf OVF.R 90 f1AVS f111RATIUN <br />