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P <br />Date 6-25-92 C_3&-2C1"_" Pubat:WOMSPermit I Z Z6� <br />Application For Bldo Dept.. _���.$� <br />PUBLIC WORKS PERM PpbhcWorks 7mr, -- <br />TO POSTIHG_547-93 total Fee S_ <br />APPI, Fee Paid S <br />Print or Type Only Balance Due S <br />Robert 6 Rhonda Reed 13085 SE 26th ST 11F201 Bellevue98005 641-0356 (h) w 454-0566 <br />Owner Mailing Address City Zip Phone <br />O _ r . J W t Ct : ! L] to - " - <br />:i a Or r._ X to r� i,::s + �: fir .-� U"i <br />Owner <br />Applicant Mailing Address City Zip Phone <br />D, scribe Proposed Work new house <br />Project Address lit known) 4309 Olympic Blvd <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable <br />• Property Lines • Centerline of street <br />• Outline and dimensions of all existing and • Indicate North <br />proposed structures on the lot • Show any proposed grading changes <br />• Existing and proposed utilities • Show measurements <br />' t <br />DO NOT WRITE BELOW THIS LINE <br />LI <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in advance - phone 259-8810. <br />r' <br />2. All wnrk shall be performed in accordance with this permit and current City of Everett Design and Construction <br />Star, o: rds and Specifications. <br />Ll3. <br />Call L cation Underground Service 48 hrs. befure you dig. TOLL FREE NUMBER 1-800.424-5555. <br />`�r 17•r;mew�L must lie.. paoe8 � r✓c+ e,��'( - "� <br />1;.nC nS cirntnilx�wl, <br />E o <br />w' <br />' ACKNOWLEDGEMENT OF CONDITIONS <br />App oved for Construction Date <br />7 <br />FINAL INSPECTION Date <br />Approved as Constructed <br />WORKS DEPARTMENT <br />CLPUBLIC <br />3200 Cedar Street <br />Everett, WA 98201 <br />Pnone: 259-8810 <br />W <br />H <br />The undersigned owner/applicant hereby agrees to 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 and to replacepublic property damaged thereby. <br />ZIP "fe <br />Signature of Applicant Date <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 />