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- �, <br /> , <br /> PuElic Wu.6s Pormil v <br /> Date 61tlg.DeD�.n • <br /> Applic:.lion For <br /> PUBLIC WORKS PERMIT PubTotalFeeFeo S <br /> Less Aoo�Foe Paid � <br /> Balance Uue $ <br /> Print or Type Only <br /> Plan Check No: C 39177 SEPA <br /> — Applicat.Date: O1/06/93 Zip Phone <br /> Owner Job Addre: 1411 11iH ST <br /> Owner: BEARCE/MEEHAN <br /> Tenant: <br /> Proposed Use: SINGLE FAMILY RESIDENCE ZiP Phone <br /> qpplicant Deac. of Worlc: <br /> REMODEL <br /> Describe Proposed Wc OFFICE SET JOB SET__�_ <br /> pppRVD FOR PERMIT: DATE�/_I_ BY <br /> W <br /> Project Address(if known) � <br /> v <br /> Attach(our(4) copies of plans tor proposed work• Draw lo scale and note the following as applicable: � <br /> • Property Lines • Centerline of slreet <br /> • Outline and dimensions of all existing and • Indicate North <br /> � proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements /� <br /> W <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS � <br /> 1.All calls for inspection shall be made 24 hrs.in advance•phone 259-8810. <br /> 2.AII work shall be peAormed in accordance wilh lhis permit and current Cily of Everett Design and Construction <br /> Standards and Specitications. ��' �� � <br /> 3.Call Location Underground Service 48 hrs.be(ore you dig.TOLL FREE NUMBER 1•800•424-5555 � <br /> /Y � <br /> � ��� �r �� <br /> ,� f � a���0' � � ���� <br /> PUBLIC WORKS PERMIT a ,(�, e � <br /> N� REQUIRED D� ��� �� ,^/ �C��C � <br /> � <br /> ' �J' <br /> DATE�9Z— �� � �� �� ��(��� O <br /> ���r� �� o- <br /> b K ��r� — <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br /> less the City of Everett irom any and all claims for damages, cosls, <br /> expensas, or causes of action that may arise because of installation <br /> and maintenance ol lhe improvement or other righl�ohway use herelo <br /> applied for and turther agrees lo remove same upon notice trom the <br /> Approved for Construction Date City and to replace public properry damaged thereby. <br /> FINAL INSPECTION Date Date <br /> Signature of ApPlicant <br /> Approved as Constructed WpRK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> � FUBLIG WORKS UEPARTMENT �8^ DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> +r�� 3200CedarSlreet F3E DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Everett,WA 98201 CADJCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259�8810 PROJECT OVER 90 DAYS DURATION. <br /> _ — / <br /> t � <br />