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�� . <br /> Date � Pu01ic Woike Permlt• <br /> Application Fer Bleq.Dept+ _ <br /> PUBLlC WORKS PERMIT P°°��°W°,M°F°° <br /> Total Fee S <br /> less AppL Fa¢Paid w5_ <br /> Print or Tyoe Only ea�a��sc.a 5 _ <br /> Plan Check No: B 39154 SEPA <br /> Applicat.Date: ��1/04/93 <br /> Owner Job Addre: 515 47TH ST Zip Phone <br /> Owner: HONTJE AAT � <br /> Tenant: <br /> Propoaed Use: SINGLE FAMILY RESIDENCB <br /> Desc. of Work: <br /> qpplicant BREAKFAST NOOK ADDN =ip Phone <br /> Describe Proposed Wor OFFICE SET JOS SET <br /> _ APPRVD FOR PERMIT: DATE_/_�_ BY <br /> � <br /> Project Address(if known) � <br /> Attach four(4)copies of plans for prop�sed work- Draw to scale and note ihe following as applicable: sc+ <br /> • Property Lines • Centerline of street ♦� <br /> • Outline and dimensions of all existing and • Indicate North V� <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measwements � <br /> DO NOT WRI7E BEl.OW THIS LINE � <br /> PERMIT CONDITIONS <br /> 1.All calls for inspeclion shall be made 24 hrs.in advance-phone 259-$$10. � <br /> 2.All work shall be peAormed in accordance with thi;permit and current City of Everett Design and Construclion <br /> Standards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.before you tlig.TOLL FREE NUMBER 1•800•424-5555. � <br /> � <br /> � <br /> PUBLIC WORKS PERMIT � <br /> NOT REOUIRE6 0 <br /> B Y ` �' <br /> DATE s � ,� a <br /> I <br /> ACKNOWLE�GEMENT OF CONDITIONS <br /> � The undersigned owner/applicant hereby agrees to hold anr save harm- <br /> less the City of Everett Irom any and all claims tor damages, cosls, <br /> eapenses, or causes of action ihat may arise because of inslallation <br /> and maintenance of lhe improvement or other right-of-�vay use hereto <br /> applied lor and (urther agrees to remove same upon nolice irom the <br /> Approved for Construction Date City and to replace public property damaged ihereby. <br /> FINAL INSPECTION Date <br /> Approved as Con;tructed Signature of Applicant Date <br /> �I4I�E3� PUBLIC WORK.i DEPARTMENT WOPK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITIiIN <br /> 3200CedarStreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> � Everetl,Wh^.820t BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE I <br /> � Phone:259�8810 CANCELLED BY THE CI7Y UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />