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� �b0lication For �-- <br /> PUBLIC �. JRKS PERMIT Da1 <br /> PUBLIC WORKS DEPARTMENT Publie Works Pertnit N <br /> 3200 Cedar Street <br /> Eveiett,WA 98201 259-8810 Building Pertnit 8 <br /> TYPE OR PRINT ONLY Pub�ic works Fee S <br /> � Owner Meliln Plart Check Nos B 53470 SEPA phone <br /> Applicat.Date: 11/OB/96 <br /> Job Addreee: 16b8 t+LORIDA DR <br /> Owner: CAFFEE DON <br /> Tanants <br /> Applicent Meilin Propoeed Uee: SINGLE FANILY 1tESIDENCE Phone <br /> Deec. of Work: <br /> NEW FOUNDATION UNDER EXISTING HOUS& <br /> Describe Proposed Work � <br /> OFFICE SET JOB SET � <br /> APPROVED FOR PBRMIT: DATB_/_/_ SY _� <br /> �/ <br /> PROJECT ADDRESS(if known) M <br /> Attach tour(4)copiea of plans tor propoaed work-Draw to scale and note the following if applicable: `i+ <br /> �Property Lines 'Outllne arid dimensions of all azlsting and proposed struetures on the lot 'Existing and proposed utflitles O� <br /> 'Centerline of street 9ndicate North 'Show any proposed greding changes 5how measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: Z <br /> 1.All calls for inspection shall be made 24 hours in advance-phone 259-8810. O <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design and <br /> Construction Standards and 3pecifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-4245555. � <br /> V♦ <br /> I I� o publ�z wavks �rn�+ re8�c�. Q <br /> � a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save hartnless � <br /> the City of Everett trom any and all claims fa damages,costs,expenses,or <br /> roved for Construction Date causes oi action that may arise beeause oi Installetion and maintenance of <br /> �P the improvament or other right•of-way use hereto applied for and lurther agrees <br /> to remova same upon nolice from the Ciry and to replace puWic property <br /> damaged thereby. <br /> FINAL INSPECTION Date Y'' <br /> Approved as Conshuetecf <br /> Signature of ApplicaM Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STAR'fED WITHIN 180 DAYS OF DATE PERMR IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />