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Y' v ^ � <br /> ,_ 7 <br /> �8t@ �� ` / /7 .r <br /> PUEIic Warka Pe�mi1• <br /> ��� <br /> Applicallon For emy.oeoc. <br /> PUBLIC WORKS PERMIT PubbcWorkaFee <br /> Tolal Fee S�-_ <br /> Leas ApO�Fee Paid � <br /> Print or Type Only BalanceDue s_ <br /> -� <br /> Plan Check No: B 42079 SEPA <br /> Applicat.Date: 09/20/93 <br /> Job Addreee: 1620 f9APLE <br /> Owner Owner: 'EBANKS JOHNNA <br /> Tenant: Z�P Phone <br /> Propoaed Uee: SINGLE FAMILY RESIDENCE • <br /> Deac. of Work: <br /> Applicant HOUSE ADDN <br /> Z�P Phone <br /> OFFICE SET JOH SET <br /> Describe Proposed Work <br /> APPROVED FOR PERMIT: DATE_/_/_ BY — <br /> Project 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 of street <br /> • Outline and dimensions ol all existing and • Indicate North � <br /> proposed structures on the bt � Show an ' <br /> • Existing and proposed utilities Y Proposed�rading changes <br /> • Show measurements <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS O <br /> 1.All calls tor inspection sheil be made 24 hrs.in advence•phone 259-8810. <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design and Constructlon � <br /> Standards and Speciftcations <br /> 3.Call Locatfon Underground Service 4B hrs.before yau dig.TOLL FREE NUMBER 1-800�424•5555. <br /> � <br /> _ " PUBLIC WORKS PERMIT O <br /> NOT REOUIRED <br /> BY ' ..�' • � <br /> DATE ` 'i i ;� � <br /> O <br />�, a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/appiicant hcreby agrees to hold and save harm- <br />� less the Ciry of Everett from any and all claims tor damages, costs, <br /> expenses, or causes of action that may arise because of instailation <br /> and maintenance of the improvement or other righFof-way use hereto <br /> Approved for Conslruction pa�e applied for and furthei agrees to remove same upon notice from the <br /> City and to replace public property damaged thereby. <br />� FINAL INSPECTION Date <br /> Approved as Consiructed <br /> Signature of App!icant Date <br /> I PUBLIC WORKS DEPARTMENT N�O'iK AUTHORIZED BY THIS PERMIT MUST BE STAqTED WITHIN <br /> 3200CedarStreet 780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />�I Everet6 WA 98207 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 OURATION. <br /> -. -_. ---- -------- <br />, . _ ------- —�_ <br /> I <br /> V <br />