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i <br /> � Applketlon For D�3te � <br /> PUBLIC WORKS PERMIT <br /> Public Works Permit N <br /> PUBLIC WORKS DEPARTMENT <br /> 3200 Cedar Street <br /> Everett, WA 98201 (425)257-8810 Building Pertnit M <br /> TYPE OR PRINT ONLY Public Works Fee$ <br /> Plan Ch�ck No: H 62794 BEPA <br /> Appllcat.L�t�: 06[21/99 <br /> Job Addr���: 6503 �l4�RCIAL 1�V6 <br /> �e� Own�r: HILLSTRI�lID DON/BRSNDI► Phone <br /> Tanant: <br /> Propo�W U�ot SINGLE f11NILY RESIDENC& <br /> Applicant Da�c. of Norks ph�e <br /> N6W CEILIN6 JOIST IN Cl1Rl1OE, TWO N8W <br /> W��►s W <br /> Describe Proposed Work _ oFsicB sax Joe sax <br /> APPROVSD FOR P8R!lIT: D71TE_/_/_ HY H <br /> � <br /> � <br /> PROJECT ADDRESS (if known) � <br /> Attach lour(4)copies plans for proposed wark-Draw to scala end nole tAe following tf applk,able: O <br /> •Property Lines •Outline&nd dimensions of all axtsdng end proposed strudures on the lot •Existing end proposetl utilitles � <br /> •Centerline ol sVeet •Intlicate Narth •Show any proposed grading changes •Show measurements <br /> DO NOT WRITE BELOW THIS LINE Z <br /> PERMIT CONDITIONS: O <br /> 1. All calls for inspection shall be made 24 hours in advance - phone (425) 257-8810 <br /> 2. All work shall be performed in accordance with this pertnit and current City of Everett Design and � <br /> Construction Standards and Specifications., <br /> 3. Call Location Underground Service 48 hrs. before you dig.TOLL FREE NUMBER 1-800-424-5555. //�► <br /> �/J <br /> ''UOLIC WORKS O <br /> NG7 �GRM(', � <br /> �RG� <br /> ?Y,�_` <br /> •A.TE.�` . ��w_` <br /> I <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned ownerlepplicant heraby agreus to hold and seve hertnless <br /> the CIty ol Evarett from any and all Gaims ror demages,coats,expenses,or <br /> prove or ns ruc on a e ceuses ol actlon thet mey erise because ol InslallaUon end maintenence of the <br /> improvement w other rightof•way use he�eto applied for and lurther egrees to <br /> remove same upan ratice from the Gy and to roplece pud(c propery dem- <br /> aged thereby. <br /> FINAL INSPECTION Date <br /> Approved es ConsWcted <br /> igia re o p ican e <br /> WORK AUhpFi�lD BY iHIS PEAMR MUST BE STAFiTEU V1rti}�NM 180 DAYS OF DAIE PEfiAMT IS ISSUED AND 7FfFEAFIER IS TO BE OL.K3QfTLY PURSUFDlO <br /> COMPLE(KNJ.hil5 PERMfT MAY BE CANCELLm BY TFE CRY UPON ANY S70PPA(3E OF WOF1C ON l}#S PRQECTOVEFi 90 DAYS DURAiIOPI <br />