5810 COMMERCIAL AVE 2016-01-01 MF Import

I - - . , Date ' -' ' -� � Puplie Worha Pe�mit� -- Application For PUBLIC WORKS PERMIT B�tlo.o�o�. Pub�ic WorMf Fee TotelFee S-� Print or T Le��Aoo�Fae P�Ia S�-- ype Only plan Check No: C 43609 0a1e��eo�. s�� Applicat.Date: 02/2q�gq SEPA Job Address: 5810 COMMERCIAL AVE Owner: JOHNSON J MICHAEL Tenant: Owner Proposed Use: SINGLE FAMILY RESIDENCE Desc. of Work: ADD FAMILY ROOM, GARAGE, LAUNDRY ROOM Z�P Phone . � Applicant OFFICE SET—JOB SET � APPROVED FOR PERMIT: DATE Z�P Phone — � �escribe Proposed Work —�—�— BY . Prolect Address(if known) � � Attach four(4) copies ol plans for proposetl work• Draw to scale and note the following as applicable: � • Property Lines • Out�ine and dimensions of all existing and • Cenlerline of street � proposed strucWres on the lot • Indicale North � • Existing and proposed utilities � Show any proposed grading changes • Show measurements DO NOT WRITE BELOW THIS LINE m PERMIT CONDITIONS O 1.All calls for Inspection shall be made 24 hrs.fn advance-phone 259•881 O. 2.All work shall be performed in accordance with this permit and current City ol Everett Design and Construction Standards and Specilications. � 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800-424•5555. � O ��lQ �V��11�� HE�� pefi ��a�NE� � BY 6 DATE 3 J 9 � O a ACKNOWLEDGEMENT OF CONDITIONS The undersigned owner/applicant hereby agrees to hold and save harm• less the Cily of Evu�ett Irom any and all ciaims for damages, costs, expenses, or causes ot action that may arise because of installation and maintenance ef the improvement or other righbohway use hereto Approved for Construction applied for and lurther agrees to remove same upon notice from ihe Date City and to repiace public properly damaged thereby. FINAL INSPECTION Approved as Constructed Date Signature ol App�icant PUBLIC WORKS DEPARTMENT WORK qU7HORIZED BY TH�S PERMIT MUST BE STAR7ED WITHIN 3200CedarStreet 780 DqYS OF DATE PERMIT IS ISSUED AND THEFEAFTER IS TO Everetl,Wq g8201 BE DILIGENTLY pURSUED TO COMPLETION. THIS PERMIT MAY BE Phone:259•8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURqTION.