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Date <br /> . PoObC WOrks Pnrmi�• <br /> Application For eioa.o�o�.. <br /> PUBLIG WORKS PERMIT PueTo4lFeeFen S - <br /> Less aoot Fee Paitl � <br /> Print or Type Only sa�a��eo„e s <br /> Owner Plan Check No: B 39558 SEPA <br /> Applicat.Date: 02 12/93 ZiP Phone <br /> Job Address: 50 5 GLENWOOD AVE <br /> Owner: BAKER WILLIAM 6 JUDY <br /> — _ Tenant: <br /> Applicant Propoeed Use: SI";LE FAMILY RESIDENCE <br /> Desc. of Work: Z'p Phone <br /> ADDITION AND REMODEL <br /> Desc�ibe Proposed WorV <br /> OFFICE SET JOB SET <br /> APPROVED FOR PERMIT: DATE_/_/_ BY <br /> Project Address(it known) � <br /> Attach tour(4) copies of plans for proposed work- Draw to scale and note the following as applicable: � <br /> • Property Lines � <br /> • Centedine of street � <br /> • Outline and dimensions ol all existing and • Indicale North <br /> proposed structures onthelol • Show any proposed grading changes <br /> • Existing and propcsed utilities • Show measurements <br /> DO NOT WRITE DELOW THIS LINE � <br /> PERMIT CONDITIONS O <br /> 1.All calls for inspection shall be mada 24 hrs.in advance•phone 259•8810. <br /> 2.All work shall be performed in accordance with this permit and current City ot Everett Design and Conslruction � <br /> Standards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.betore you dig.TOLL FREE NUMFiER 1-$00-424•5555. <br /> � <br /> 'UBLIC V�'OR�� pERM1T O <br /> NOT REOUIRED <br /> BY ' � <br /> DATE � � `v' � �- <br /> / !�--- � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br /> less the Gry ol Everett Irom any aod all claims for damages, cosls, <br /> evpenses, or causes ol action that may arise because of installation <br /> and maintenance of the improvement or olher righFoFway use hereto <br /> Approved for ConsVuction applied for and further agrees to remove same upon nolice from the <br /> Date City and ro replace public property damaged thereby. <br /> FINAL INSPEC110N Date <br /> Approved as Constructed Signature ol Apphcant Date <br /> PUBLICWORKSDEPARTMENT WORK AUTHURIZED BY THIS PERMIT MUST BE S1i;riTED WITHIN <br /> 3200CedarStreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everetl,WA g8201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:259�8810 CANCELLE�BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATIC'1. <br />