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puei¢waiks Permli• <br /> Date <br /> Bl�p.�eo�.• --- �- <br /> Ppplication For _ <br /> PUBLIC WORKS PERMIT PueTo�FeeFee g _ <br /> Less Aoo�Fee Pele 5 -- <br /> Balanca0ue � <br /> Print or Type Only <br /> SEPA <br /> Plan Check No: B 42�43 P Phone <br /> Owner Applicat.Date: 09/16/93 . <br /> Job AdOwner: CH�IN ROBERER DR <br /> Tenant: <br /> Proposed Use: SINGLE FAMILY RESZDENCE p phone <br /> Applicant Desc. of Work: <br /> SWIMMING POOL <br /> Describe Proposed Work — OFFICE SET_�JOB SE1'_�_— <br /> � pPPROVED FOR PERMIT: DATE_/_I, BY <br /> W <br /> Project Address(il known) � <br /> � <br /> Attach four(4) copies ot plans lor proposed work- Draw to scale and note ihe �ollowing as applicable: � <br /> • Property Lines O Centerline of street <br /> • Outline and dimensions of all existing and • Indicale North <br /> proposed structures on the lol • Show any proposet grading cFanges <br /> • Existing and proposed utilities • Show mezsuremenls � <br /> DO NOT WRITE BELOW THI."i LINE � <br /> PERMIT CONDITIONS � <br /> 1.All calls for inspection shall be made 24 hrs.in advance-phone 259•8810 <br /> 1.All work shall be performed in accordance with this permit and c�rrent City ot Everett Design and Construction <br /> Standards and Specitications. � <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FHEE RUMBER 1•S00•424-5555. <br /> � <br /> PUBLIC WOpKS pF.RM1T �, <br /> NOT pEOUIRED � <br /> DY >i✓�� O <br /> DAT E��_ <br /> ___. a <br /> AGKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applican�hereby agrees to hold and save harm- <br /> less �he Ciry ol Everel� from any and all claims tor damages, costs. <br /> expenses, or causcs ol action Ihat may arise because ol ins�allation <br /> and maintenance ol the improvement or other righ�-oF�vay use hereto <br /> applied for and Wrther agrees lo remove same upon notice irom �he <br /> qpproved lor Construction �a�e City and to replace public properry damaged ihereby. <br /> FINAL INSPECTION Date Dale <br /> qpproved as Construded Signature ol Applicant <br /> W6RK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> PUBLICWORKSDEPARTMENT 180 DAYS OF C4TE PrRM1T IS ISSUED AND THEREAFTER IS TO <br /> ��Y� 3200 CedarSireet I BE DILIGENTLY YURSU[D TO COMPLETION.THIS PERMIT MAY BG <br /> ���T Everett,WA 98201 CANCELLES BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone 259-BE!0 PROJECT OVER 90 DAYS DURATION. <br />