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__ ---�,� <br /> � ..hcetion For ' <br /> PUBLIC 'iNORKS PERMIT °e'e—_----_ —_ <br /> PUBLIC WORKS OEPMTMEtvT Public J�Orks Permit M <br /> 3200 Ceder Slre+et <br /> Everatt,Wq g8207 259-8810 BullAing Permit N <br /> TY?E OR PRINT ONLY Publk Works Fee S <br /> Plan Check Noc B 52479 SEPA <br /> Applicet.Dete� 08/02/96 <br /> Owner Job Addreaet 14Z7 100TH ST SW SP 62 Phone <br /> Owners SRINNER CHARLES/JOCELYN <br /> Tenant: <br /> Pronoeed Uee� NOBILE HOMr: <br /> Hp�:'icant Deec. of Worki Nhone <br /> MOBILE HOME PLACEHENT AT FAIRWAY ESTATES <br /> Describe Proposed Work_ oFFzcE SET _JOB EET � <br /> — A:FROVED FOR PERMIT: DATE__/_/_ BY _ � <br /> _ � <br /> �/ <br /> PROJECT ADDRE3S(if known) ___ __ _ � <br /> Attaeh/our(4)coplee of piane lor proposnd vrorlc-Draw to scele antl note the lolbwing P eppilceble: O <br /> 'PropeRy Lines 'Outline entl dimans;cns of ell exlsting end proposed structures un the lot •ExlstlnH and proposed utllitles <br /> 'Centerllne ol street •Indicete No1h •Show eny propo:ied gretling chnnges •Lhow maesuremants � <br /> DO NOT WRITE BELOW THlS LINE <br /> PERMIT CONDITIONS: � <br /> 1.All calls for Inspection:;hall be made 24 hours in advar�r.e- phone 259-8810. � <br /> 2.All wori<shall be perfocred In accordaoce with thls permit and current Clty of Everett Deslgn and <br /> C:onstructlon Standard::and Speclfications. <br /> 3. Call Location Undergroimd Service 48 his. betore you di�. TOLL FREE NUMBER 1-800•424-5555. ` <br /> '_. <br /> v/ <br /> O <br /> a <br /> PU�iLIC WORNt �BRM�T <br /> NOT NEOUIl16� <br /> BY.�� , �p <br /> IIME.�- .a ,-�---- <br /> ACKNOWLEDGEMENT CF CONDITIONg <br /> The undenlgneU owner/appllcant hereby ai)iaes to hold end seve harmless <br /> the Cny ol Everelt Imm any nnd all clnim�ror demeges,costs,ezpenses,or <br /> Approvad lor Constructlon Dxte causes ol ectlon thal may erlse be�ceuse of Installatlon and melntenance ol <br /> ibe Improvement or olher righl-ol way use heretc applled lor end luhher egrees <br /> to rnmove same upon nolica Irom Ihe f,lly end 10 replace publlc property <br /> damaged Iheraby. <br /> FINAL INSPECTION Dote <br /> Approved as Construcled <br /> Signature ol Applicant Date <br /> WORK AUTNORIZED BY THIS PERMIT MUST BF STARTED WtTHIN 180 DAYS OF DATE PERMIT IS ISSUED ANC THERFAFTER IS TO RE OILIGENTLV PURSUED TO <br /> COIdPLETION.THIS PERMIT MA'I BE CANCELLED BY THE CITY UFON ANY STOPPAGE OF WORK ON iHIS PFOJECT GVER 90 DAYS DURAT;ON. <br />