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� alron For <br /> PUBLIC VI�.�RKS PERMIT Daro� <br /> PU 3LIC WOPKS DEPARTMENT Publk Works Permit� <br /> 3200 CeOar Streat <br /> Everett WA 98201 259•8810 <br /> Buildinp Permlt M <br /> TYPE Ofi PRINT ONLY Pubik Works Fee S <br /> Plan Ch�ck No: C 55337 86PA <br /> Owner — Appllc�t.Datft 06/04/97 <br /> Job 11ddt���t 611 11LVERSON BLVD Phona <br /> Ownui MILLMIIN MIIC6 <br /> 2�nentt <br /> Appllcant Propo��d U��i 8IN6LE FAMILY RESIDENCE <br /> D��c. of Work� Phons <br /> ADDITZON/REMODBL <br /> Describe Proposed Work <br /> — OF►ICE 8ET JOB 6ET � <br /> _ TPPROVED FOA PEAMIT: DATE_/_/_ BY � <br /> � <br /> PROJECT ADDRESS(if known) � <br /> Attach four(4)copiee of plans for proposed work•Drew to scale end note the lollowing II applicable: � <br /> •Property unes butline and tlimenslone ol all exlsting gnd proposeC structures on the bt •Exlsting and proposed utllitles O <br /> 'Cenlerline ol etreet •Indicate Nonh 5�ow any proposed grading changea �Show measurementa <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: � <br /> 1. All calls for inspection shall be made 24 hours in advance- phone 259-8810. <br /> 2.All work shail be periormed in accordance with this permit and current City of Everett Design and O <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs, before you dig. TOLL FREE NUMBER t-800-424-6536. � <br /> � <br /> O <br /> '•;�RLIC yy � <br /> NUi �MUI^�AA111 <br /> ��� <br /> ��•�--••-{���- <br /> i.1TC . '�� <br /> ACKNOWLEDOEMENT OF CONDITIONS <br /> The undenignad ownar/applicant haroby agraea to hoid and eave harmleas <br /> the City ol Everett Irom any and all claima tor damepsa,coste,axpensea,or <br /> Approved for Construction Oate eauses of aclion that may ad�e because of inetallallon and malnfenance ol <br /> the improvement or olhar ripht-ol-way use hareto applied lor and further agreea <br /> to remove same upon natice Irom the City antl to roplaca puElic propsrty <br /> tlamageC lhereby. <br /> FINAL INSPECTION Date <br /> Approvetl as Constructed <br /> Signature ol Applicant Date <br /> WORK AUTHORIZED 9Y iHIS Pf RMIT MUST BE STApTED WITHIN t80 DAYS OF DATE PERMIi IS ISSUED AN�THEREAFfER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLEfION.THIS PERMI7 MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />