3419 BELL AVE 2018-01-02 MF Import

Datey2/__ Z Application For PUBLIC WORKS PERMIT Print or Type Only Plan Check No: C 36343 SEPA Applicat.Date: 04/14/92 Job Addrs: 341h BELL AVE Owner: DALE, BRIAN 6 CYNTHIA Owner Tenants Proposed Use: Desc. of Work: ADD 2 CAR GARAGE, FAMILY ROOM 6 DORMER Applicant OFFICE SET JOB SET Describe Proposed APPRVD FOR PERMIT: DATE _/_/_ Project Address (if known) Public Works Permit. o _ Pubbc Work. Fee T. F.. L..r APpt Fee Paid . 9a1anc. Du. $ Zip Phone Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: • Property Lines • Centerline of street • Outline and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements DO NOT WRITE BELOW THIS LINE NINE PERMIT CONDITIONS 1. All calls for inspection shell be made 24 firs. 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. Calf Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800-424.5555. FINAL INSPECTION Date Approved as Constructed PUBLIC WORKS DEPARTMENT 321`10 Cedar Street Everett, WA 98201 Phone: 259-8810 Y ACKNOWLEDGEMENT OF CONDITIONS Lu z O G,. 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 City and to replace public property damaged thereby. Signalure of Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.