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DatF 3�`/��`� <br />qppliGaGon For <br />pI;BLIC WORKS <br />Print or Type Only <br />IIoyden Realty, <br />Inc. <br />1429 B <br />�,,.:w�,�,�,,,�/ �Y��f�.--� <br />oia�, o.n� . ��J.. � /� 1-__� _ - _ <br />PERMIT PuoiicWorwePoe S aA,UU _ <br />ro�.� �d. <br />1.ne �nri �ee Fe�e � t�----��'-- <br />Paience �m s � -- <br />Inc., dba J& D 6u11ders, <br />Msllinq Address <br />GvereCt ';8201 <br />c�iy z'p <br />1429 8roudway, Everett 98201 <br />__--- ..-,--- Z f p <br />68138 <br />252-116E ___ _ <br />252-1166 <br />nnnn�. . . _ _ ._ _ .- <br />___ _ _ _ <br />New Single Fnm1�Y reeidence �_--------"" -- <br />Descrlue Proposed Work _, ___, — �� <br />Prolect Address III knowN �1� - •• �-- - - -- 11C2i�ie. <br />• CeNerline ot sVeet <br />Attach fom (41 coPies ol pinns lor p�oposed work � Draw lo scale ar.d nole 1he IolloNing as a <br />� Property Lines � Indicrle Norlh <br />N Shov. unY P'oPOEHd g�.��1�n9 �.hang�s <br />� p�, Iline and dimensione o� all eKisting end <br />proposed atrudures or Iho lol � �h ,µ moesureme �is <br />• EzlatinB and proposxd ulilil�es —�_���� <br />_ _... .�.,. woirc a�i OW THIS lIN[ <br />PERMIT CONDITIONS <br />1 AII cnlla lor inspectlon �,hal. be mode 24 hrs. in advance - phone 259•��' � <br />2. All work ehnll be perlormed in accoidnnr.e with Ihis Pe�mu and current City o� Everetl DesiNn aind Ccnstrur.tion <br />StandarAs erA Specilicatio�.is. <br />3 Call Lor,ation Unde�g�nunA Senu=�'�� ���' ����0"' ��°O ����' »�� FRFE NUMUGA 1•BOO•424•555.i. <br />l— � <br />�/ <br />Approved lor C� <br />FWAL INS� <br />Approved es C <br />rvr�rlt <br />� <br />:/ -�'��.. j /�--- � _ <br />� OP�B. <br />tJ <br />p�IBLiC W�AKS DEPARTMENT <br />3200 Ceda� Streel <br />f.�p•rV A'JA9R:U1 <br />Phn� :5?BN'? <br />Z <br />Z <br />O <br />;•[�P,N�Wi-EDGEMGNI OF GONDITiONG <br />1 i,�• ��i„f„�.,yne•,f �wnei/epphcanl herehV ag�nes to hotd Hntl sme naim- <br />,�ys ���,, �,�y �� �verett Irom any and all r,laims for dameges. cosls, <br />end�meinlen'nnce9ulgthe mPoovemenl oY o�hR b9h1 ol-wey use�herelo <br />C;tyllond'to epace,p�eblc,� ���e�y'danoa�ed herebyn nohce from thn <br />% _ ,� <br />� � - ' %� �,-� .-� ' 's - <br />�: `���-'__. �ata <br />--' i-- <br />Sfgnature of 0 � ��I�:ant <br />1v00RDA STOF DATE PEFIAIS�SERM11E�U�5J�BiHFREPF ER IS1'TU <br />BE DILIGEN7LV PURSUFD TO CO�•�� �-�T�n�� T�{iS FF�h��T �dn'I E'f. <br />f.AVGRIEn Bv TIiF- rITV UPON ANY til� �1'I�aG! Cir W�>I�� fvV 11�1- <br />�'Hi iJfl;� �l�'I.R �n� ��qy`- lil'cAll(liJ <br />