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�a�e � ' PUCIie Wo�k�Permil� <br /> AppliCa�ion Fof e�ao�Deot+ <br /> PUBUC WORKS PERMIT PuOTmHFea`°° : . <br /> uca�oo�Fee rue S_ <br /> Print or Type Only Plan CheCk No: B 46094 SEPA B��anceDue ' <br /> Applicat.Date: 11/O1/94 <br /> Job Address: 4626 COLBY AVE <br /> Owner: EDQUIST JERRY/M JEAN <br /> Tenant: <br /> Proposed Use: SII4GLE FAMILY RESIDENCE <br /> Owner Desc. cf Work: Zlp Phone <br /> REBJILD COVEAED PORCH <br /> Applicant OFFICE SET JOB SET ��P Phone <br /> APPROVED FOR PERMIT: DATE_/_/_ BY <br /> Describe Proposed Work _ <br /> W <br /> Project AdCress(if known) � <br /> Attach four(4)copies of Ftans lor proposed work- Uraw to scale and note the following as ap��icable: � <br /> • Property Lines • Centerline of slreet � <br /> • Outline and dimensions ol all existing and • Indicate North � <br /> proposed structures on the lot • Show a�y proposed gratling changes <br /> • Ezisting and proposed utilities • Show measurements � <br />� DO NOT WRITE BELOW THIS LINE O <br /> PEiiM1T CONDITIONS <br /> 1.All calls for inspection shall be made 24 hrs.in advance•phonv 259•8810. � <br />, 2.All work shall be pertormed in accordance with chie permil 2nA curronl C�ry ol Everrtl Design and Consiruction <br /> Standards and Speci(ications. <br /> 3.Cail Lxation Underground Service 4B hre.before you dig.TOLL FREE NUMBER 1-800-424•5555. � <br /> I O <br /> ^�B h'OTWR DUIREl1 MIT � <br /> � <br /> RY O <br /> �. z -� y <br /> •ATE <br /> a <br /> ACKNGWLEDGEMEN7 OF CQNDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br /> less the Cily ol Everett Irom any and all claims for damages, costs, <br /> ezpenses, or causes o� action that may arise because of installation <br /> and maintenance ol Ihe improvement or other righhof-way use hereto <br /> applied for and further agrees to remove same upon notice Irom the <br /> Approved for Construction Date City and to replace publlc property damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed Signalure ol Applicanl Date <br /> ������ PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS P[RMIT MUST dE STARTED WITHIN <br /> 3200CedarStreel 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA 98201 BE DILIGENT�Y PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Fhone:259•8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVEF 90 DAYS DURATION. <br />