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MWwat�on For pa P. <br /> � PUBLIC '. ORKS PERMIT publicWorksPermnll <br /> PUBLIC WORKS DEPARTAIENT <br /> 3qpp Cedar Street <br /> E�� YVAS. ;�;t 259-BB10 BuildingPertnitN <br /> •+/orks Fee S <br /> TYPEORPRINTONLY plan Check No: B 51122 SEPA <br /> Applicat.Date: 03/18�96 <br /> Job Addrs: 543i B OADWAY <br /> Owner: RIFNSR PHIL Phone <br /> Tenant: <br /> Owner proposed Use: SINGLE FAMILY RESIDENCE — <br /> Deec. of Work: <br /> REMOVE CORNER OF HOUSE FOR SHORT PLAT • phone <br /> CONDITIONS <br /> Appliwnt JOB SET � <br /> OFFICE SET .�—� <br /> pesCfibe PfOpOSed WOrk APPRVD FOR PERMIT: DATE_/_I_ HY � <br /> �— �/ <br /> PROJECT ADDRESS(f known) � <br /> Atlach four(4)copies of plans tor proposed work-Draw to scale and note the tollowing N apP��cable: �� <br /> sed structures on the lot •Ex�sting and proposed utilities <br /> ■prop¢Ay Lines 'Outline and dimenslons oi.II existing and Po� rading changes •Show measurements ' <br /> •Centerline ot street '�ndicate North Show any prop 9 � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIOiJS: O <br /> 1.All calis for inspecterformeid n acco dance with this permit and�current C'ity of Everett Design and <br /> 2.All work shall be p � <br /> Construction Stand�rds and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-55 . � <br /> O <br /> a <br /> �UE�.iG '.vCNKS PERM�' <br /> R�U�f REGUIREI� <br /> �y=!J� _ <br /> •i.T'c. 3�jyli._». <br /> T <br /> ACKNOWLEDGEMENT OF CONC7ITIONS <br /> The undersigned owner/applicant hereby agrees fo hold�a Sds e Pen es,or <br /> the City of Evereri from any and all clalms for damages, <br /> causes oi action thal may9 rise be�use ot installalied tor a d furlhera9�r <br /> Date 1helmprovementorotherri ht-ol-wa useheretoapp' <br /> Approved for Conswction to remove same upon notice from the G:y and to replace public properry <br /> damaged lhereby. <br /> Date <br /> FINAL INSPECTION <br /> Approved as Constructed Date <br /> Signalure of Applicant <br /> COMPLETION.RTM S P RM T MAY BE CANCEBLEDTBY TNE CIIYIUPON ANY S OPPAGE OF WORK ON THIS PROJEC 0 ER 90 DAYS DULRATION.Y PURSUED TO <br /> � <br />