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Date ^ � PuEl�e Work�Pom�t• <br /> AppllCeti�.. rot B�av.��o���_ <br /> PUBLIC WORKS PERMIT �Oio1�F�eFta = <br /> Leu ADC�Fee P��E S <br /> B�I�nu Du� _ <br /> Print or Type Only <br /> Plan Chack No: B 40208 SEPA <br /> Owner Applicat.Date: 04/12/93 Phone <br /> Job Addreee: 1614 EDGEMOOR LN <br /> Owner: ROTHNIE JAMES S <br /> Tenant: <br /> • Applicant Propoaed Uee: SINGLE FAMILY AESIDENCE Phone <br /> Deec. of Work: <br /> REMODEL OF DECK AND ADD WINDOW <br /> � <br /> Daecribe Proposed Work — OFFICE SET JOB SET <br /> APPROVED FOR PERMIT: DATE_/_/_ BY__ <br /> W <br /> Pro�ect Address(8 known) � <br /> Attach tour(4)coples of plens for proposed work- Draw to scale and note the tollowinp as applicable: � <br /> • Property lines • Centerline of sireet � <br /> • Outline and dimensions of all ezisting and � Ind�cate North <br /> proposed etructures on the lot � Show eny proposed gradinp chenges <br /> • Exletinp and proposed utilNies • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All calis for inapectbn ahall be mede 24 hra in advence•phone 259�8810. � <br /> 2.All work ahell be peAormed in accordance with this permit end current City of Everett Deslyn end Constructfon <br /> Standarda and Speclficationa <br /> 3.Cell Location Underpround Service 48 hra.before you dig.TOLL FREE NUMBER 1•800�424•5555. � <br /> O <br /> � <br /> ?UBLIC WORKS PERMIT � <br /> NOT REQUIREO <br /> BV i .' � �-�— � <br /> DATE `�-�Z - �3 A <br /> li <br /> ACKNOWLEDGEMENT OF CUNDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save hnrm• <br /> less the City of Everett Irom any and all claims for damages, costs, <br /> expenses, or causes ot acHon that may arise because ot InstalleNon <br /> and mainlenance of lhe improvement or other righhof-way use hereto <br /> apptied lor and further agrees to remove same upon notice irom the <br /> Approved for Construction Date Cily and to replace public propeAy damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed Sig�alure of Applicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> �A�� PUBLIC WORKS DEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS .TO <br /> 3200 Cedar Street BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Everet4 WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259•88t0 pROJECT OVER 90 DAYS DURATION. <br />