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� <br />Date <br />qpplication For <br />PUBLIC WORKS PERPJIIT <br />Print or Type Only <br />Plan check No: 8 48688 <br />Applicat.Date: 06/22/95 <br />Job Aa�ner: HESSEN WEEW DR <br />PUD��c Wor4t Permil � __ <br />B�ao. oeo�. • <br />Pu�Irc Wo�ka iee S -- <br />Tolel Fee <br />Less Rool Fee PaiO 5— <br />Ba�>�ce Oue $ — <br />SEPA Phone <br />Applicant Tenant: :; <br />Propoeed Use: SINGLE AMILY RESIDENCE <br />Desc. of Work: <br />ADDITION (NOOK) AND DECK <br />Describe Proposed Work _ <br />OFFICE SET JOB SET <br />APPAOVED FOR PEAMZT: DATE_/_/_ gY. <br />Project Address (il known) <br />Atlach lour (4) copies ol plans lor proposed work - Draw to scale and note the lollowing as applicable: <br />• Property LineS <br />• Outline and dimensions of all existing and <br />proposed structures on the lot <br />• Eaisting an.1 proposed uliliti ; <br />• Centerline of slreel <br />• Indicate Norih <br />• Show any proposed 9rading changes <br />• Show measurements <br />LI <br />Phone <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in advance - phone 259-8810. <br />2. All work shall be peAormed ��n acwrdance with this permit and current City of EvereU Design and Construction <br />Standards and Specitications. <br />3. Call Location U�cerground Service 49 hrs. belore you dig. TOLL FREE NUMBER 1-800-424•5555. <br />rUB f!o.tWR QUIREI� MfT <br />"!Y� — <br />; <br />J nT E <br />App�oved lor Consiruclion Date <br />FINAL INSPECTION Date <br />ApProved as Cons�ruc�ed <br />���I=� PUBLIC WORKS DEPARTMENT <br />3200 Cedar Sireet <br />Everelt, WA 98201 <br />Phone:259�8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />H <br />�w <br />_ / <br />� <br />O <br />� <br />N <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the Cily of Everett Irom any and all claims lor damages, cosis. <br />expenses, or causes of aclion Ihat may arise because ol installation <br />and mainlenance ol the improvement or other righl-ol�way use hereto <br />applicd lor and lurther agrees to remove same upon notice Irom Ihe <br />City and to rep�ace public properly Cama9ed ihereby. <br />Signalure ol Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PUFtSUEC� TO C061PLETION. THIS PEPMIT MAY �E <br />CANCELLED BY TNE CITY UPON �NV STOPPAGE OF \h'ORK ON THIS <br />PROJ[CT OVER 90 Dti1'S DU17�1TION. <br />