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� �uc4c WOMa Permll� ��� <br /> Date OIJq.Ocol• <br /> qpplicalion For _ <br /> pUBLIC WORKS PERMIT °"°'„"'°'"„°° <br /> TOIrIFee �— <br /> LG55/O�L Fn!PdiC 5--- <br /> Baiance ove S_—� <br /> Print or Type Only <br /> Plan Check No: B 45307 SEPA phone <br /> Owner Applicat.Date: OS/17/94 <br /> Job AdOwner: JDHNSONHJAMESWF <br /> Tenant: �– — <br /> Proposed Uee: POOL / SFR Phone <br /> Applicant DEBC. Of WOZk: <br /> ABOVE GROUND POOL <br /> 7escribe Proposed Work – OFFICE SET •70B SET <br /> APPROVED FOR PER`tIT: DATE_/_/_ BY ��� <br /> � <br /> 'roject Address(il known! � <br /> 4ilach four(4)copies of plans br Vropused wur�.• Drdv: ta scala antl ncie U�e loilcwing as apUlicable: � <br /> • Property Lines • Cenlerline ot slreet <br /> • Ir.dicate Norlh , <br /> • Oulline and dimensions ol all ezisting and � chow any r,roaosed grading changes <br /> proposed struclures on Ihe lol � $how measurements /� <br /> • Existing and prOposed ulili�ies W <br /> DO NOT WRITE BELOW THIS LINE o <br /> PERMIT CONDITIONS ^ <br /> 1.All calis for Inspection shall be made 24 hrs.in advance-phone 259-8810. <br /> 2.All work shall be pedormed in accordance with this permit and current City of Everetl Design and Construction � <br /> Slandards and Specitications � <br /> 3.Call Location Underground Sarvice 48 hrs.before you dig.TOLL FREE NUMBER 1-800•424•5555. <br /> � <br /> � <br /> PUBLIC WORKS PERMIT � <br /> NOT REOUIREII O <br /> 'ty�`J' _ � <br /> ,iATE �'� <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersianed owner/applicxnt hereby agrees lo hold and save harm- <br /> --' � less the Gty ol Everett Irom any and all claims lor tlamages. costs. <br /> � expenses. o� causes ol aclion thal ma/�aris^ because ot instaltalion <br /> ; �nd maintenance o! Ihe improvement or other right-of-way use hereto <br /> Iapp��eC lor and turther agrees lo remove same upor notice Irom Ihe <br /> �roved for Construction Date � �;;y anG to replace public properry damaged lhereby. <br /> i <br /> IAL INSPECTION � Date I Date <br /> �roved as Constructed I <br /> Signa�ure ol Applicant <br /> WORK AUTHORI'LED BY THIS PERMIT MUST BE STARTED WITH <br /> � PUBLICWORKSDEPARTMENT tA0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> �i;�� 3200 CedarSlreet ' BE DILIGENTLY PURSUED TO COMPLETION.TNIS PERMIT tAAY 0E <br /> � Everelt,WA 98201 I GANCELLED BY THE C�TY UPON ANY S70PPAGE OF WORK ON THIS <br /> Phone:259•881U PROJEC7 OVER 90 DAYS DURATION. <br />