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Date <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Plnn Check No: B 42042 <br />Applicat.Date: 09�16/93 <br />Job Addreee: 67 4 WILLOW RD <br />Owner: PAGE STEVE <br />Tenant: <br />., <br />Pueik worlu Wrmu • <br />ama. o•o�.. _ <br />WOIK WOA� Fr <br />Totsl F�� s <br />Leu Apot F�� P�IE S <br />SEPA ���^�aou� i <br />Proposed Uee: SINGL& FAMILY RESIDBNCB <br />Owner Deec. of Work: <br />ADDITION AND BAYVIEW WINDOW <br />ApP�ke�� OFFICE SET JOH SET <br />AYPROVED FOR PERMIT: DATE_/_/_ BY <br />Describe Proposed Work _ <br />Projecl Addreas (if known) <br />�P Phone <br />Attach lour (4) copies of plans for proGased work- Draw to scale and nota Ihe following as applicable: <br />• Property Lines • Centerline ol street <br />• Outline and dimenaions ol ell existing end • Indtcate North <br />proposed atructwea on the lot • Show any proposed grading chenges <br />• Exlatinp end proposed utilities • Show measurements <br />Phone <br />PERMIT CONDITIONS <br />1. All calls for Inepectlon shall be mede 24 hra. In edvance • phorte 259-881 O. <br />2. All work ahell be pertortned ir, eccordance wiM thin permit end curtent Ciry of Everetl Deafpn end Construdion <br />Stendarde end Specificetlons. <br />3. Call Location Underpround Service 48 hra before you dip. TOLL FREE : IUMBER 1-800-4245555. <br />WOpKS PERMIT <br />PUBIIC pE0U1RED <br />N D�T� <br />BY ���� <br />DAZE <br />Approved for Conslruction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />�PUBLIC WORKS DEPARTMENT <br />3200 Ceder Street <br />Everett, WA 98201 <br />Phone: 259-BB70 <br />ACKNO'NLEDGEMENT OF CONDITIONS <br />W <br />H <br />� <br />The undersigned owneri.:�plicant hereby apraes to ho�d and save harm• <br />less the Ciry of Evereit frnm any and all claims for dameges, costs, <br />expenses, or causes of cct,�n thet may arise because ol installetion <br />and maintenance of Ihe improvement or other righhof-way use hereto <br />applied for and further agrees to remove same upon notice irom the <br />City and to repla�e public property damaged thereby. <br />Signature of Applicant Oate <br />WORK AUTHORIZED BV THIS PERMIT MUST BE STAFTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND TY,EREAFTER IS TO <br />BE �ILIGENTLV PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVEF 90 DAYS DURATION. <br />