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�— <br /> .c � ,,, ,w�,.,�,. `! ' ��� � � <br /> , ,. ,m,. _ <br /> Date-1-4 �C — — <br /> w.ui Unni . -.- _"" __.____ <br /> Apphr.ahnn f pr <br /> FUBLIC WORKS PERMIT °„"'""'°,"-`"° -- --- <br /> ,��.��.. s-- <br /> � ino�nn� ��ePnA S_ � <br /> � � � <br /> �.�.���o�. s �4 <br /> Print or Type Oniy <br /> .O x <br /> >yv'�i � G,�,c T1 (r��d`� '�3- y�f,J v <br /> rx � � / �?�., >> s � ��'�.,.•„ ��.��/ <br /> H 93 �^ SC — �;�ihn�AtlAress Cdy Zip Phone <br /> � x� Owne� <br /> �� �1 �' / � ff `j�'''� �l ,� 9i�-9735— <br /> �y��-1 -� �u �/ .i//� �(.v J T��uS. '^c �_.�_!��'� _ c c�' <br /> r Maihnq Atldress Gty Zip Phone <br /> pppl�t:xnt <br /> Q�T�1 � � <br /> ,� .'„ � < <✓ L �✓., J . <br /> p� � Describe Proposad Wnrk �'l"^ � � ' // —+� �� � �' i�L� <br /> ��g <br /> /�i�X//Ylvh'1 -�` ' i `1r_� S <br /> � W <br /> � H� — <br /> g y Prolecl Address 1�1 knownl ���"��- — — � <br /> H <br /> n �y � <br /> � Attach lour I�1 copies o�P�a�s�or proposed work- Drnw lo sca�e antl not��h�lollowm9 as applicable � <br /> � • Property Unes • Cenlerime ol slreel <br /> �]fA • Outline and dimensions ol an eaistmg antl • Indicate North <br /> H O y proposed slruclures on ihe lot • Show any praposed 9ratlm9 chnnyes <br /> • E��stin9 onA p�oposed ulBdieS • Show me��.sureme�ts M <br /> W <br /> DO NOT WRITE BF.LOW TNIS LINE O <br /> PERMIT CONDITIONS � <br /> �i 1.All cells lor Inspection shell be made 24 hrs.in edvence�phone 259•8810. <br /> 2.All work 9hall be pedormed in eccordence with Ihis permi�antl wrrenl City ol Everol�Design end Construclion <br /> � � � Stendards end Speciliunlions. <br /> �! �� 3.Call Loca�ion UnderprounA Servite 4B hrs.belo�e you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> '� ' �r �,y,�, �� �. /�'�/� /f c! ��-7 �!YC iI O <br /> �XS�A�/7"" /L• c, ` <br /> ,- - Gt �� /,/,-��� ,1� �>��t-, G�j'. ��,,y � y-£-`�t � <br /> w �' N <br /> ` � O <br /> � _ .r ,S ,�- �� � ,5 17-,e� �-S ���c�a �7 7 .5: �'� �-" t `- � � <br /> � <br /> / jTj t/� �1' E".'/r;I i'2y^ C=ir1�� <br /> � ( C� ,�2-r, Lr ii j�C' S �/a 7`z"s t 1 - � YS o/, "T-a-F�2r-�� <br /> /� ��c -� <br /> �� ��� ` � ���d//'� ��f CKNOWLEDGEb1ENT OF CONDITIONS <br /> �G✓ `�' � <br /> � Thn unAeiSi�nvtl ownei'ApP���:anl hereby agrees l0 hold nnd 5ave harm� <br /> �' � ----'"— less Ihe Ciq ol Everetl Irorr. any and 2�I claims lor tlama�es. cosls. <br /> � <br /> e.penses or causes ol actio� Ihal may nnse because ol insta atmn <br /> , �j�/ /'A/' � C� „�' '"7 anA maint^�ance al the improvemeN or nlher n�hDobwny usr hereto <br /> , // ,�� ��-� ��_�— appi�F�d lor anA turther agrees lo �emove same upon not¢e Irom Ihe <br /> ��� ApryrneA IWLBnstrur.ti �� Date �,tY����I lo iePlace PublTc ytoPerty dama9ed Ihereby <br /> . � � /� <br /> / / - ! �__ ! <br /> _.-( �Date � T'_ `�y /'� (, � <br /> f�INAL INSP[CTION � Sigi alwe o App icanl Dale <br /> Approued xs Constructed ' // <br /> ' W HK AU I10R12Efl BY TW/S PEPMIi MUST BE STAR7ED WITHIN <br /> � PUBLICWORMSDEPARTMENT 1H0 ��YS OF DATE PLRMIT IS ISSU[D AND THEREAFTER IS TO <br /> � 9200 Cednr Stroel BE DIUGENTIV PU�7�UED 10 COMPLCTION THIS PERMIT A7A1 BE �� <br /> Eveictl.WA 98?0� CANCRLED AV THC CITV UPON ANV STOPPAG[OP WOF7K ON THIS <br /> Phnn�� 759-l1H10 P�'OJfCi OVER 90 GAYS D'JRATION {�� <br /> � <br />