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Date Public Wods Permii• <br /> Applicalion For eiap.oeo�.• <br /> PUBLIC WORKS PERMIT PueGCWoasFee <br /> Talal Fee S— <br /> less AOGI Fee PaiE S <br /> Print or Type Only Bel�nce Oue S <br /> Plan Check No: C 37372 SEPA <br /> Applicnt.Date: 07/14/92 <br /> Job Addre: 2208 OAKES <br /> Ow�er Ownet: PAYEA DAVID Phone <br /> Tenant: • <br /> Propoeed Uee: SINGLE FAMILY RESIDENCE <br /> Deac. of Work: . <br /> REHAB 9505F HOUSE <br /> Applicant Phone <br /> OFFICE SET JOB SET <br /> Describe Proposed Work — pppRVD FOR PEAMIT: DATE_/_/_ BY <br /> W <br /> Prolect Address(if known) � <br /> Attach four(4)copies of plans for proposed work• Draw to scale and note the following as applicable: � <br /> • Property Lines • Centerline ol street � <br /> • Outline and dimensions of atl existing and • Indicate North <br /> proposed structures onthelot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All calls for fnspectlon shall be mede 24 hrs.in ativance-phone 258-8810. � <br /> 2.All work shell be pertormed in eccordance with lhis permit and curtent City of Everett Design and Construction <br /> Stendards and Specifications. <br /> 3.Call Locatlon Underground Service 48 hrs before you dig.TOLL FREE NUMBER 1•800-4245555. � <br /> i i / <br /> �� \ O <br /> �(/�G �, Cc�.--z`.=/2�. �,... C �'�"''�/��.t�:�cc.t.�<J� <br /> , '/�� � <br /> / /S–j z � <br /> O <br /> a <br /> ACKNOWLEDGEMENT np CONDITIONS <br /> The undersigned ow�er/applica�t hereby agrees to hold and save harm- <br /> less the City of Everett irom any and all claims tor damages, costs, <br /> ezpenses, or causes of action ihat may arise because of installatfon <br /> and mainlenance ot the improvemenl or other right•ol•way use hereto <br /> applied lor and further agrees to remove same upon notice from the <br /> Approved for Construction �a�e City and to repiace public property damaged thereby. <br /> FINAL INSPECT�ON Date <br /> Approved as Constructed Signature of Applicant Date <br /> � PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CedarStreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett WA 98201 BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Phone:259•8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />