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Date <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Owner <br />Applicant <br />Describe Proposed Wo <br />Project Adoress Uf known; <br />Plan Check No: <br />Applicat.Date: <br />Job Addreee: <br />owner: <br />Tenant: <br />Proposed vee: <br />Desc. of Work: <br />DECK <br />H 44987 <br />07/22/94 <br />911 BROADWAY <br />WOLD ARVEN/PEGGY <br />SFR/DECK <br />SUE <br />SEPA <br />PVOLC WO�hi Permtl / <br />B��q. Deo�. • <br />Vuni�c Wo�ks Fee 5 <br />Totel �ee <br />Less 400�. Fee Pa�E 5 <br />Balance Oue S <br />Z�p Phnnq <br />OFFICE SET JOB SET - — <br />Z�p Phone <br />APPROVED FOR PERMIT: DATE_/_/� $Y <br />Altach four141 copies ot plans fo� u�opo>ed wo�K � Drav: ra,�:ai�, a:�a ncie ma'oiluwm9 as anplicahie: <br />• Property Lines <br />• Outline and dimensions of all exisGng and <br />proposed slructures on ihe �o� <br />• Existing and proposed ulilities <br />• Centerline nl street <br />• IrCical? North <br />• Snow any r,ronased gradiny chances <br />• Show measurements <br />PERMITCONDITIONS <br />7. All calls for inspection sha�l be made 24 hrs. in advance • phone 259•8810. <br />2. Ail work shall be performed in accordance with this permit and current Cily of Er�rett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBEH 1-800•424•5555. <br />PUBLIC WORKS PERMIT <br />NOT RECUIRED <br />RY <br />nATE 7 z % <br />Approved for Construction Dalr. <br />FINAL INSPECTION <br />Approved a5 ConSiructed <br />�A�'e� PUBLIC WOfiKS DEPARTMENT <br />3200 Cedar Street <br />�� Everell, WA 9B201 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />H <br />�w <br />Y / <br />The!inder5iqned owner/appliG2nt hereby agree5 �o hold and save harm- <br />� iess the Cdy o� Everett Irom any and ali claims for tlamages. costs. <br />; e•uenses. or causes of action that may aris= because ol instailalion <br />-j- anA mainlenance o! Ihe improvement or other righ}-ol-way use heielo <br />i�ppi:r;c; lor and lunner agrees lo remove same upon nolice Irom the <br />Cdy and lo replace public properiy damaged Ihereby. <br />Date Date <br />Signature of Applicant <br />'NORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />190 DAYS OF DATE PERMIT IS ISSUEO AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WOFK ON THIS <br />