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�"�i� PPlication For r-. <br /> PUBLIC �JORKS PERMIT Da,,. <br /> PUBLIC WORKS DEPARTMENT Public Works Pertnit q <br /> 3200 Cedar Sireet <br /> Everett,WA 98201 259•8810 <br /> Building Permit M <br /> NPE OR PRINT ONLY <br /> Public Works Fee$ <br /> Owner Plan Check No: B 56568 SEPA <br /> App licat.Date: 09/23/97 Phone <br /> Job Addreee: 30921 1ST AVE SE <br /> Owner: BAILEY WILLIAM <br /> Applicant Tenant: <br /> Proposed Uee: SINGLE FAMILY RESIDENCE Phone <br /> Deec. of Work: <br /> � D@SCfl68 Pf0(JOSBd WO�k_ CONSTRUCT CARPORT <br /> OFFICE SET JOB SET � <br /> APPROVED FOR PERMIT: DATE_/_�_ gy <br /> _ � <br /> PRO,JECT ADDRESS(if known) � <br /> Atlach tour(4)coples of plans for proposed work-Draw to scale and note the following il applicahle: W <br /> •Property Lines •Outline and dimensions of all existing and proposed structures on ihe lot •Existing and proposed utilities O <br /> •Centerline of street •Indicata North •Show any proposed grading changes •Show measuremenis <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspection shall be made 24 hours in advance- phone 259-8810, <br /> , 2. All work shall be performed in accordance with this permit and current City of Everett Design and O <br /> ♦ � Construction Standards and Specifications. <br /> ! 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. ` <br /> r <br /> >:IDUC 4vpRh5 PERdli�i � <br /> kU'� REUUIRr_i O <br /> �'r�._._ � . Y. <br /> fATL-._ _ �'._� _____. <br /> ACKNOWLEDGEMENT OF CQNDITIONS <br /> The undersigned owner/applicant hereby agrees to hold antl save harmless <br /> ihe City of Everett Irom any and all claims for damages,cosis,expenses,or <br /> Approved lor Constmction Date causes o(action ihat may arise becacse of installation and maintenance of <br /> tha improvement or other right-of-way use hereto applied for and;uriher agrees <br /> to remove same upon notice from lhe City and to replace public property <br /> damageC ihereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed <br /> Signature of Applicant Date <br /> WOkK AUTHORIZED 8Y THIS PERMIT MUST BE STAFTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLEfION.THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE Of WORK ON THIS PROJECT OVER 90 DAYS�URATION. <br />