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Date I <br /> P„ebc woih�Pe�mn. <br /> Applica�ion For eioo o�oi . <br /> PUBLIC WORKS PERMIT °��°T;,:Fee`�e_ S_ <br /> �e»�oo�Fae Paia S <br /> Print or Type Only B�i�nceDue s <br /> Plan Check Nos B 44230 SEPA <br /> QW�ef Ap ].icat.Date: 04/27/gq <br /> ��b Addreee: 835 309TN ST SE Z�P Phone <br /> Owner: AVILA NICK .7A <br /> Tenant: <br /> Propoeed Uee: SFR/WORKSHOP <br /> Applicanl Deec. of Work: <br /> NEW ACCESSOAY Pt�C;WORKSHOP Z�p Phone <br /> Describe Proposed W� OFFICE SET JOB SET <br /> - APPROVED FOR PERMSTs DATE_/_�_ gy <br /> .'roiect Address lil known) � <br /> Attach four�4) cupies ol plens lor proposed work• Draw to scale and nole the lollowing as..�olicable: � <br /> • Property Lines • Centerline ol Street <br /> • Outline and dimensions ol all existinp and • Indicate North � <br /> proposed structures on tne lot • Show any proposad gratling changes <br /> • Eristing and proposed utilitics • Show measurements <br /> �� �DO NOT WRITE AELOW THIS LINE � <br /> PEIiRiiT CONDITIONS O <br /> 7.All calls lor inapectlon ehell be made 24 hrs.In advance•phone 259•8810. <br /> 2.All work�hall be performed In eccordanca wllh this permit end current City ol Everelt Design end Conslrucllon � <br /> Standards Rnd Spe�iNcetions. <br /> 3.Call Locatfon Underground Serv�ce 48 hrs.belore you tlig.TOLL FpEE NUMBER 1•BW424•5555. <br /> � <br /> PUDLIO WOAK3 PERMIT O <br /> N T REOUIRED � <br /> BY 4E�n.� <br /> DATE Z � <br /> � <br /> a <br /> L <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> _ ihe untleisiqnrd��wneyapplicant hereby eArees to hold and 9[ve haim� <br /> less Ihe Cily ol Everett Irom any and all claims fo� damages, cosls, <br /> expenses, or causes ol ection thet mey erlse beceuse ol inslallation <br /> and mainlenance ol the improvemenl or other �ighl�of�way use he�e�o <br /> Approved lor Constructlon Dale applied lor and lur;har agrees lo remove same upon notice Irom the <br /> Ci1y and lo replace public property demaged thereby. <br /> FINAI INSPECi�ION Da�c <br /> Approved as Construc'ed Signnlure ol Applicant <br /> Dale <br /> ���� PUBL�C WOHKS DEPARTMEtlT WORK AUTHORI2ED BY THIS PEFMIT MUS? BE STARiED WITHIN <br /> 3200CndarStreet 180 DAYS OF DATE PER?AIT IS ISSUED AND THEfiEAFTER IS TO <br /> °verelt,WA 98201 BE DILIGENTLY PUFSUED TO COMPLETION. THIS PERMiT MAY BE <br /> Phone:259�8E10 CANCELLED BY THE CITV UPON ANY STOPFAGE OF N'017K ON Th11S <br /> PROJECT OVER 90 DAYS DURATION. <br />