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GaTe ` pu011c Wnrks Parmll� <br /> Applicat�nn For BICq.Depl.• <br /> PUBLIC WORKS PERMIT PubToelFeeFee s <br /> Less Appl Fee PeiE $ <br /> Print or Type Only Balanca Due s <br /> Plan Check No: B 41761 SEPA <br /> Owner Applicat.Date: OS/20/73 i Phone <br /> Job Address: 2230 LOMBARD � <br /> Owner: STEELE JIM <br /> Tenant: <br /> Proposed Use: SINGLE FAMILY RESIDENCE <br /> Applicant Desc. of Work: � Phone <br /> NEW FOUNDATION <br /> Describe Proposed Work _ OFFICE SET JOB SET <br /> — APPROVED FOR ?ERMIT: DATE / / BY <br /> W <br /> Project Address(if known) � <br /> Attach four(4) copies of plans for proposed work• Draw to scale and note the(ollowing as applicable: � <br /> � Property Lines • Centerline o(street � <br /> • Outline and dimensions of all existing and • Indicate North <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show me2surements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1.All calls for inspection shall be made 24 hrs.in advance-phone 259-881 G. � <br /> 2.Ail work shall be performed in accurdance with this permit and current City of Everett Design and Construdion <br /> Standards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800-424-5555. � <br /> „ O <br /> _ 3 V � <br /> 3 ,�; PUBLIC WORKS PERMIT � <br /> 11 a3d g 3 1 N t`10T R OU RED <br /> , � all8l: : BY � ,�3 73 ' i � <br /> DATE � <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br /> less the City ol Everetl Irom any and all claims for damages, costs, <br /> expenses, or causes of action that may arise because of installation <br /> and maintenance ot the improvement or other right•of•way use hereto <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 I�SPECTION Date <br /> Approved as Const�ucted Signature of Applicant Date <br /> �ArI� PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 32COCedarSireet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett.WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:259-8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />