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Date ^ P�e�,�wo,M.P<,m,�. <br /> Application For Bieq �eo� • <br /> PUBLIC WORKS PERMIT o„^"�W�-�=F<a <br /> To�a�<<. s <br /> Less 400i c>e Pam S <br /> Print or Type Only ea�a��eo�� s <br /> Plan Check No: B 44549 SEPA <br /> Appllcat.Date: 06�01/94 <br /> Owner Job Addie: 220 8 GRANp Ph�nr, <br /> Owner: BERG JOHN M <br /> Tenant: <br /> Deec�ofdWork� SINCLE FAMILY RESIDENCE __ <br /> Applicant CRSATB UNFINISHED BASHHENT Phone <br /> Describe Pr000sed Work OFFICE SET JOB SET ___ <br /> APPRVD FOR PERMIT: DATE_ <br /> �_/_ BY - <br /> -------------------- W <br /> Prolect Address ld knownl __ _ ___�_ _ _ � <br /> Attach fow�41 coP�es of P��ns fo� propuseJ wn-s � Drav: ta sc,�i.,.r+a nc.te tna'oiluwing as apGhcab�e: � <br /> • Property Lines • Centerline nl s1reNt � <br /> • Oulhne anC dimensions ol ail e.isUng �nA • IrCiw10 North <br /> propo5etl slructures on ihe lot ! Show any r,r000sed�ratliny chanaes <br /> • ExistinQ and proposed utilities • Show measurements � <br /> DO NOT WRI7E fiECOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All calls for inspection shall be maCe 24 hrs.in advance•phone 259•8810. � <br /> 2.All work shell be peAormed in accordance with this permit and current City of Everett Design and Construction � <br /> Standards and Specifications. <br /> 3.Ceil Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-$00-424•5555. � <br /> •'UBUC WORKS PERMIT O <br /> NOT REOUIRED <br /> nY_ �-;� � <br /> iiATE U" � —� 5L <br /> � <br /> O <br /> a <br /> ACKNOWLECCiEh1ENT OF CONOITIONS <br /> ihe�.mdersig�ed owner/app��cant hereby agrees to holtl anC sace harm• <br /> -- '-��-� le5s :hN Gty c� Everett Irom any and aU daims lor dama9ea WstF <br /> : e�uenses. or �auses ol acuon that may ans= because ol in5:anaUer <br /> � � -�- and m,vntPnance o! Ihe improvement or other ngh}-oi-way use heretn <br /> ; a:n��ed �cr and lurther agrees to remove same upon nolice hom tne <br /> Approved for Construction Date � Gty and to replaca pubhc properry damaged thereby. <br /> I <br /> i <br /> FINAL INSPECTION Dale I <br /> Approved as Conslructed Signature ol Applicant Date <br /> PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PEFMIT MUST BE STARTED WITHIN <br /> 3200CedarStreet �80 DAYS OF D4TE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> EveretL WA98201 BE DIL�GENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:259�8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PRO.IECT OVER 90 DAVS DURATION. <br />