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� PUBLIC 4�IORKS PERMIT °�' <br /> PUBLJC W�RKS DEPARTMENT PubBc Works Pertnk It <br /> 32'0 Cedar Street <br /> Everett,WA 98201 259-8810 Building Pertnit N <br /> TYPE OR PRINT ONLY Public Works Fee� <br /> Plen Check No: C 61611 S6P1� <br /> �ef 71pplicat.Dst�� 02 16 99 <br /> Job Addres�: 43 C owN DR Phone <br /> Owners HACHMAN GLSN/SU311N <br /> Tanants <br /> Propot�d U��i SINGLS F1IMILY RESIDENCS <br /> Applicant De�c. of Works phone <br /> ADDITION OF H7ITHROOM <br /> Describe Proposed Work_ o1+Ftce SET JOB SBT 1 I � <br /> W <br /> APPROVED FOR PBRMIT: DATE_/_/_ BY � <br /> � <br /> �/ <br /> PROJECT ADDRESS(if known) � <br /> Attach four(4)copies of plans for proposed wor{c-Draw to-cale and note the folbwing if aFpNcable: � O <br /> •PropeRy Unes 'Outlfna and dimerubru ot all existfng and proposed structurcs on the bt 'Ezisting end pmoosed utfl0ies <br /> 'CeMMine ot street •Indlcate North 5how eny proposed grading changes 'Show rtroasurertronts � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: � <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 thfs permit and current City of Everett Design and <br /> Construction Standards and Specificatlons. <br /> 3. Call Location Underground Service 48 hrs. before you dfg. TOLL FREE NUMBER 1-800-4245555. N <br /> � PU� tiOTWOFlKUIRt A�61 � � <br /> .Y._._� . O <br /> .AT�____z.��.:�. o. <br /> ACKNOWLEDGEMENT OF CONDI110N5 <br /> � The undersigned ownx/applieant hereby agrees ro hold and seve harmlesa <br /> iha City of Everett from any end all claims 1or damagm,cwts,expensee,or <br /> Approved for Construction Date causes of actlon that mey arise beeause of Installation and maintenenea ot <br /> tha improvement orother right-ol-way use herto applied for arW further agrees <br /> to removrsame upon nottce M1om the City end to replace puWic pioperty <br /> dameged lherehy. <br /> FINAL INSPECTION Date <br /> Approved as Constructed <br /> Sfgnature of AppOcant Date <br /> WORK AUTHORIZED BY 7HIS PERMR MUST BE STARTED WITHIN�180 DAYS OF DATE PERMfT IS ISSUm AND iHEREAFiER IS TO BE DWGENTLY PURSUED TO <br /> COMPLETION.IHIS PERMIT MAY BE CANCELLED BY THE CfTY UPON ANY STOPPAGE OF WORK ON 1HIS PROJECT OVER 90 DAYS DURATION. <br />