2509 57TH ST SW 2016-01-01 MF Import

Date_— Public Works Permit. Application For aidg Dept PUBLIC WORKS PERMIT Pub To Wprea Fee cFee S Less April Fee Paid S r Balance Due S Print or Type Only Plan Check No: B 42369 SEPA Applicat.Date: 10/14/93 Job Address: 2509 57TH ST SW owner: REYNOLDS GARY Owner Tenant: !ip Phone Proposed Use: SFA/POOL Deec. of Work: POOL Applicant :to Phone OFFICE SET JOB SET Describe Proposed Work _ APPROVED FOR PERMIT: DATE_/_/_ BY W Project Address(if known) Attach four(4)copies of plans for proposed work- Draw Ic scale and note the following as applicable: • Property Lines • Centerline of street /^ • Outline and dimensions of all existing and • Indicate North v♦ proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements �A DO NOT WRITE BELOW THIS LINE WO PERMIT CONDITIONS 1.All calls for Inspection shall be made 24 hrs.In advance-phone 259.8810. 2.All work shall be performed In accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3.Call Location Underground Service 48 hrs,before you dig.TOLL FREE NUMBER 1.800.424.5555. O PUBLIC WORKS PERMIT NOT REQUIRED BY O DATE 0 ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett from any and all claims for damages, costs, expenses. or causes of action that may arise because of installation and maintenance of the improvement or other right-of-way use hereto applied for and further agrees to remove same upon notice from the Approved for Construction Date City and to replace public property damaged thereby. FINAL INSPECTION Date Date Approved as Cons!ructed Signature of Applicant WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN PUBLIC WORKS DEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO 3200 Cedar Street BE DILIGENTLY PURSUED r0 COMPLETION. THIS PERMIT MAY BE Everett,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS Phone:259.8810 PROJECT OVER 90 DAYS DURATION.