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r .. <br /> Dat e a�m�c wo,�.ce,m.n. <br /> Uioo Deo��• <br /> Application For <br /> PUBLIC WORKS PERMIT Pu�TolalFeeFeO S <br /> Lesi noo�Foc Paie S <br /> Babnce Due S <br /> � �� Print or Type Only <br /> ��y Plan Check No: 8 38858 SEPA <br /> H Applicat.Date: 11/30/92 <br /> � y y Owner Job Addre: 1431 AUCICER AVE Zip Phone <br /> x Owner: WEATHERHOLT ALICE <br /> M i� Tenant: <br /> ��� Proposed Use: DECK/SFR <br /> y � Deec. of Work: <br /> qpplicanl SUNDECK FOR JACUZZI SZTTING ON GROUND PAD Zip Pnone <br /> "'�q h�i '� W/ 6' PRIVACY FENCE W GATE AND STEPS <br /> NMr <br /> �',�3 Describe Propose� OFFICE SET JOB SET <br /> t�3 y�d APPRVD FOR PEAMIT: DATE /_/_ BY <br /> OH <br /> ��'g W <br /> zyy� Project Atldress(il known) � <br /> r i-+ H <br /> C7� Altach lour(4)copies ol plans lor proposed work-Draw to scale and nole the following as applicable: � <br /> nd y • Property Lines • Centedine ol streel /^ <br /> �C • Outline and dimensions ol all eaisting and • Indicale North V� <br /> �'�� proposetl structures on the lot • Show any proposed grading changes <br /> y y • Existing and pwposeA utililies • Show measuremeNs �/� <br /> O Ui W <br /> DO NOT WHITE BELOW THIS LINE O <br /> � PERMITCONDITIONS <br /> f � 1.All calls for inspection shall be made 24 hrs.in ativance-phone 259•8810. � <br /> 1 2.All work shall be pedormed in accordance with this permit and current City ol Everett Design and Consiruclion <br /> Standards and Specilications. <br /> C� 3.Call Location Underground Service 48 hrs.belore you dig TOLL FREE NUMBER 1-500•424•5555. � <br /> O <br /> � �� :'UBLIC WORKS PERMIT � <br /> � NOT REOUIRED I '/� <br /> i �� � °" "� � J O <br /> DATE <br /> a <br /> ��_i <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> `�, <br /> The undersigned owner/applicant here6y agrees to hold and save harm� <br /> less ihe Cily of Everett Irom any antl all claims for damages. costs, <br /> expenses, or causes of aclion that may arise because ol installation <br /> - and maiNenance ol ihe improvement or other righboi�way use hereto <br /> applied lor and lurther agrees to remove same upon notice Imm Ihe <br /> Apprr,ved lor Construclion �a�e City and to raplacz pu6lic properly damaged Ihereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed Sig�,!ure o�Applicant �ate <br /> � PUBLIC WORKS OEPARTMEN7 VJORK AUTHORIZED DY THIS PERMIT MUST BE STARTED WITHIN <br /> 'V� 3200CedarSlreet 180 DAVS OF DATE PERMIT IS ISSUED ANO THEREAFTER IS TO <br /> i' Eve�ett,WA 9B201 BE UILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Phone:259-8870 CANC[LLED BY TIiE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />