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Date_-- <br />Avu.cain For <br />PUBLIC WORKS PERMIT <br />Print Cr Type Only <br />PWlk wmt. Pomnr — <br />Blaa. o.Pl . <br />Paoow <br />rr.e Per $ <br />dau Awt Fee Pad S <br />eauur D.. $ <br />Plan Check No: <br />B 42105 <br />SEPA <br />_ <br />Owner <br />Appllpat.Date: <br />09422'93 <br />Job Address: <br />34.1 HOYT AVE <br />Owner: <br />SWANSON JIM <br />Tenant: <br />Proposed Vae: <br />SINGLE FAMILY RESIDENCE <br />Applicant <br />Dead. of Work: <br />REPLACE ONE 2—STORY <br />DECK / COVER <br />EXISSTIVC <br />REAR DECK <br />Describe Proposed Work <br />OFFICE SET <br />JOB SET <br />APPROVED FOR PERMIT: DATE_/_/_ <br />BY <br />Project Address (if known) <br />Attach lour (4) copies of plans for proposed work - Draw to scale and note the following as applicable. <br />• Property Lines • Centerline of street <br />• Oull::.a and dimensions of all existing and • Indicate North <br />proposed structures on the lot • Show any proposed grading changes <br />• Exisling and proposed utilities • Show measurements <br />Phone <br />PERMIT CONDITIONS <br />I. All calls for Inspection ii be made 24 hrs. in advance- phone 259.8810. <br />2. All work shall be performed in accot dance with this permit and current City of Everett Design and Construct Ion <br />Standards and Specifications. <br />3. Call Location Underground Sera, a 48 his. before you dig. TD.L FREE NUMBER 1.800.424.5555. <br />PUBLIC WORKS PERMIT <br />NOT REQUIRED <br />DATE <br />—_ <br />DATE a <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett WA 98201 <br />Phone: 2548810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />F <br />01 <br />z <br />0 <br />Cl) <br />O <br />a <br />The undersigned owner/applicant hereby agrees'o hold and save harm <br />less the City of Everett from any and all claims for damages. costs. <br />expenses. or causes of action that may arise because of Installation <br />and maintenance of the improvement or other right-of-way use hereto <br />applied for and further agrees to remove same upon notice from the <br />City sad to replace public property damaged thereby. <br />Signature of Applinnt Dale <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 THIS <br />PROJECT OVER 90 DAYS DURATION. <br />