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Date <br />.ippl(catlon FOr <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Owner <br />Applicant <br />Plan Check No: B 36520 SEPA <br />Applicat.Date: 04/27/92 <br />Job Address: 3830 �EDERAL �9'�.��-� <br />Owner: OLESON WAYNE <br />Tenant: <br />Propoeed Uee: POOL <br />Deac. of Work: <br />INSTALL PRIVATE FIBERGLASS POOL <br />PuEllc Worke Parml� • <br />eiea. o.o�. • . �(c � <br />Public Worxs Fas <br />Tot�l Fea S <br />Leaa ApO� Fes PUO S <br />Balance Due i <br />Describe Proposed Work _ OFFICE SET � <br />JOB SET <br />APPROVED FOR PERMIT: DATE_/_�_ gy ' <br />Proiect Address (if known) <br />Attach four (4) copies of Dlans for proposed work • Draw to scate and note the following as applicable: <br />• Property Lines • Centerline of street <br />• Outllne and dimensions of all existing and • Indicate North <br />proposed structures on the lot • Show any proposed grading changes <br />• Existing and Droposed utilities � Show measurements <br />Phone <br />Phane <br />PERMIT CONDITIONS <br />1. All cells for Inspaction shall be made 24 hrs. in advance- phone 259-8810. <br />2. All work shall be peAormed in accordance with thia permit and current City of Everett Deslgn and Conatructlon <br />Standerda end Speciflcationa <br />3. Call Locetion Underground Service 48 hrs. before you d(g. TOLL FREE NUMBEti 1-800-4245555. <br />� ,/ / /� / <br />I"U�1�2 l�!'c�v/�S l"�/t'�,� /�d� ����.d'ed <br />�aT� � /�� r �,�z,�ti ��� S f � c����-� �-��� � <br />--- =-� <br />5,��� ��� — s��i -�� � �� <br />�, / %�-,�� t; a-, <br />����� � `� �'o <br />/�r-,✓1 , £ <br />1 <br />W <br />H <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />^� � ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City of Everetl Irom any and all cleims foi damages, coat; <br />expenses, or causes of action that may arise hecause of installation <br />and maintenence of lhe improvement or ather righbof•way use herato <br />applied for and further agrees to remove same upon notice from the <br />Approved for Construction Date City and to replace public property damaged thereby. <br />FINAL INSPECTION <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 CedarSireet <br />Everett WA 98201 <br />Phone: 259�8810 <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS �TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON ?HIS <br />PROJECT OVER 90 DAYS DURATION. ' <br />