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Date <br />( <br />AOP�ication For <br />PUBLIC WORKS PERMIT <br />Print orType Only <br />Plan Check No: B 45089 SEPA <br />Applicat.Date: 07/29/94 <br />Ownei Job AddiE99: 1340 MADRONA AVE <br />Owner: RITCHART BRTAN & DEBBIE <br />Tenant: <br />Propoeed Uee: SINGLE FAMILY RESIDENCE <br />AppliCant Desc. of Work: <br />CARPORT� DECKS� EXTEND GARAGE <br />Describe Proposed Work ,_ OFFICE SET JOB SET <br />APYROVED FOR PERMIT: DATE_/_/_ <br />Project Address Iif known! <br />� <br />Attach four 141 copies ol plans lo� uroposed wu�n � Drav: U.caio am,l ni.le Uid 'olWwmy as apphr.ab�e: <br />t Property Lines <br />• Oudine and dimenslons ol au exishng and <br />proposed sVur.tures on ihe lo� <br />• Existmg and proposed utilities <br />Pudm Woda Permp • <br />BIJg. pe0� � <br />Pueuc wo.es Fee - <br />Tataioee S <br />lefa Aool iee Paia S <br />Balance Cue $ . <br />• Centerlino ql StreN� <br />• Irr_ical� Narth <br />• Snow any r,ropoSeA gratlina Chanae5 <br />• Show measurements <br />Phnnr. <br />Phone <br />PERMITCONDITIONS <br />1. AI� calls for inspection shall he made 24 hrs. in advance • phone 25�J-8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-$00•424•5555. <br />Approved lor Conslruction <br />PUBLIC WORKS PERMIT <br />NO REQUIREn <br />�Y — <br />=iA7E S � � <br />ACKNOWLEDGEh1ENT OF CONDITIONFi <br />W <br />H <br />_ / <br />� <br />O <br />ihe �.i�ders�qned owner/apphcant nareby agre�s to hold and sa•:e harm- <br />� � Ie55 IhN l,d'y 0� CVGfE�� I(0111 any antl al� claim5 iOf tlamages. cosls. <br />; eyuenses. or causes of acllon that may ans= beCause of inrallation <br />�� -�- ancf maint?nance o! �he improvement or other righ{-of-way use heieln <br />- I aan��eC 1or and iurther agrees to remove same upon notice hom Ihe <br />a�� � Cd,v and to replace public properiy damaged thereby. <br />FINAL INSPECTION Date <br />Approved as Constructed <br />�A�I�� PUOLIC WORKS DEPARTMENT <br />3200 Cedar Slreet <br />Everett, WA g8207 <br />Phane:259-8810 <br />Signature ol Applicant Date <br />WORK AUTHURIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COM1IPLETION. THIS PERMIT MAY BE <br />GANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PRO.IECT OVER 90 DAYS DURATION. <br />