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Date � ''� , , PUEIic Works Parm�t• <br /> . � aiao.o.o�.• <br /> Applicetion For <br /> PUBLIC WORKS PERMIT PublicWark�F�� <br /> To�.�F.. s <br /> Lefa AOV�Fee Pu0 S <br /> Print o�Type Only Plan check No: B 44428 <br /> SEPA B�i�nca Dua = <br /> Applicat.Date: 05/18/94 <br /> Job AdQwner: PENNICKAAJ A� <br /> Tenant: <br /> Propoaed Use: SINGLE FAMILY RESIDENCE Phone <br /> Owner Desc. of Work: ' <br /> BUI1.D 6 FOOT PRIVACY TRELLIS ON REAA DECK <br /> Applicant <br /> OFFICE SET JOB SET Phone . <br /> APPROVED FOR PERMIT: DI�TE_/_/_ BY <br /> Describe Proposed Work _ <br /> W <br /> Project Address(if known) _ � <br /> Attach four(4)copies of plens lor proposed work• Draw to scale and note the following as applicable: � <br /> • Property Lines � Centerline of slreet � <br /> � Outline and dimensions of all axisting and • Indicate Norlh <br /> proposed structures on Ihe lot � Show any proposed grading changes <br /> • Existing and proposed utilities • Show meas�rements /� <br /> W <br /> DO NOT WRITE BELOW THIS LINF. O <br /> PERMIT CONDITIONS � <br /> 1.All calls for inspectbn shell be made 24 hrs.in advance•phone 258•8810. <br /> 2.All work shall be peAormed in accordance with lhis permit and current City of Everett Design and Construction <br /> Standards and Specificetions. � <br /> 3.Call Location Underground Service 48 hrs before you dig.TOLL FREF NUMBER 1•800-424•5555. <br /> O <br /> � ����� N <br /> �''�� O <br /> � <br /> ��{� a <br /> ACKNOWIEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm• <br /> less ihe Cily of Everett irom any and all claims lor damages, cosls. <br /> expenses, or causes ol action Ihat may arise because of installation <br /> and maintenance ol the improvement or other righfof-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 properry damaged thereby. <br /> FINAL INSPECTION Date Date <br /> Approved as Consiructed Signature of Applicant <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> ��r� PUBLICWOFKSDEPARTMENT 180 OAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 Cedar Street BE DII.IGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Everetl,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259•8810 PROJECT OV[R 90 DAYS DURATION. <br />