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i <br /> Date <br /> PUEIic Worka oermil• <br /> Applicatlon For eiac.oea�.e <br />' PUBLIC WORKS PERMIT PubTol�FeeFee s <br />, <br /> �ees aoo�Fea raie S <br />� Print or Type Only 0a�e��a o�, s <br /> Owner Plan Check No: C 41779 SEPA <br /> Applicat.Date: OS/23/93 Zip ohone <br /> Job Address: 2017 26TH ST • <br /> Owner: FOSHEIM GENE <br /> Tenant: <br /> Applicant Propoeed Uae: DUPLEX Zip Phone <br /> Desr, of Work: <br /> CHi? pROJECT — NEW FOUNDATION, WINDOWS� <br /> Describe Proposed Wor PLBG, ELEC <br /> OFFICE SET JOB SEY <br /> APPROVED FOR PERMIT: DATE_�_�_ gy <br /> Project Address(if known) � <br /> Attach four(4) copies of plans(or proposed work• Draw to scale and note the following as applica�le: � <br /> • Property Lines • Centerline of street � <br /> • Outline and dimensions of all existing and • Indicate North <br /> proposed structures on the lot • Show any proposed greding changes <br /> � • Existing and proposed utilities • Show mezsurements <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS O <br /> 1.All calls for inspection shall be made 24 hrs.in advance•phone 259•8810. � <br /> 2.All work sha�l be peAormed in accordance with this pen;iit and current City o(Everett Design and Construction <br /> Standards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800-424-5555. <br /> � <br /> - �� � � � e g alva O <br /> �-c�-��e � <br /> � <br /> aadinoad loN V+ <br /> lll'1kl3d SNHOM �il8fld <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The�undersigned owner/applicant hereby agrees t�hold and save harm• <br /> less Ihe Cily of Everett Irom zny and all claims for damages, costs, <br /> exFenses, or causes of action that may arise bec3use of installation <br /> anc maintenance of the improvement or other righbo(-way use hereto <br /> Approved for Construction Date aPF�ied for and furiher agrees to remove same upon notice (rom the <br /> Cit}�and to replace public property damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed Signature ot Applicant Date <br /> �A�I�� PUBLIC WORKS DEPARTMENT WOAK .4UTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CedarStreet iB0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY 6E <br /> Phone:259-8810 CAflCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />