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Date Pum¢work.Pe,md. <br /> Application For Bldg Deer . <br /> PUBLIC WORKS PERMIT PumlaFea <br /> lalel FeFee S <br /> Lee.APP[ Fee Paid S. <br /> Print Or Type Only Plan Check No: B 46574 SEPA 9.l.eoe Due S <br /> Applicat.Date: 12/28/94 <br /> Job Address: 2528 58TH ST SW I.OT 14 <br /> Owner: COUNTRYWOOD HOMES <br /> Tenant: <br /> Proposed Use: SINGLE FAMILY RESIDENCE <br /> Owner Desc. of Work: Phone <br /> NEW DECK <br /> OFFICE SET JOB SET <br /> Applicant — Phone <br /> APPROVED FOR PERMIT: DATE / / BY <br /> Describe Proposed Work _ <br /> W <br /> Project Address(if known) -- <br /> Attach four(4) copies of plans for proposed work• Draw to scale and note the following as applicable: <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 measureme Pis <br /> DO NOT WRITE BELOW THIS LINE 0 <br /> PERMIT CONDITIONS <br /> 1.All calls for inspection shall be made 24 hrs.In advance•phone 259.8810. <br /> 2.All work shall be performer In accordance with this permit and current City of Everett Design and Construction <br /> Standards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOIL FREE NUMBER 1.800.424.5555. z <br /> 0 <br /> UBLIC WORKS PERMIT <br /> NOT REQUIRED (Y <br /> 9Y ODATE > <br /> Ise <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm. <br /> less the City of Everett from any and all claims for damages, costs, <br /> expenses, or causes of action that may arise because of installation <br /> and maintenance of the improvement or other right-of-way use hereto <br /> applied for and further agrees to remove same upon notice from the <br /> Approved for Construction Date City and to replace public properly damaged thereby. <br /> FINAL INSPECTION Date - <br /> Approved as Constructed Signature of Applicant Dare <br /> PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200 Cedar S20ireel 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS T("1 <br /> Everett, da 9 tree BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:2598810 CANCELLED BY THE CITY UPON ANY STOPPAGE:OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />