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Date <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Onl� <br />Plan Check No: C 39605 SEPA <br />Appli.cat.Date: 02/18/93 <br />Owner Job Address: 5217 EAST DR <br />Owner: FABELLO ROBERT & JEANETTE <br />Tenant: <br />Proposed Use: SINGLE FAMILY RESIDENCE <br />ApPiicant Desc. of Work: <br />REMODEL — FINISH EXISTING BASEMENT <br />Describe Proposed Wor OFFICE <br />Project Address (if known) <br />JOB SET <br />APPROVED FOR PERMIT: DATE_/_/_ BY <br />PucLG \vorAs Permil � _ <br />Bmp Dco� � <br />Public Wo�ka F�e <br />TotaiFee g � <br />less Appl Fce Pa�O $ __ <br />Balance O�o $ _ <br />Z�P Phone <br />ZiP PhOn� <br />Attach four (4) copies of plans for proposed work • Draw to scale antl note the following as applicable: <br />• Property Lines <br />• Outline and dimensions ol all existing antl <br />proposed siructures on the lot <br />• Exis�ing and proposed utilitiet <br />• Centerline of street <br />• Indicate Norih <br />• Show any proposed grading changes <br />• Show measurements <br />PERMIT CONDITIONS <br />1. All calls for inspaction shall be made 24 hrs. in advance • phone 259-8810. <br />2. All work shall be performed in accordance with thfs permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 4B hrs. before you dig. TOLL FREE NUMBER 1•800•424•5555. <br />PUBLIC WORKS PERMIT <br />NOT REOUIRED <br />BY '�l' <br />DATE = 'Z % 3 <br />Approved lor Construction Date <br />FINAL INSPECTION Date <br />Approved as Conslructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everetl, WA 98201 <br />Phone:259�8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />� <br />� <br />� <br />0 <br />a <br />The undersigned owne�/applicant hereby agrees to hold and save harm• <br />less the City of EvereU from any and all claims for damag�s, cosls, <br />expenses, or causes ot action that may arise because ol installation <br />and maintenance of Ihe improvement or other righhohway use hereto <br />applied tnr and further agrees to remove same upon notice Irom tne <br />City and tc replace public property damaged Ihereby. <br />Siqnature of Appli�ant Date <br />WORK AUTHOHIZED BY THIS PERMIT MUST BE STARTF'J WITHIN <br />780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFiFR IS TO <br />BE DILIGENTLY PURSUED TO CCMPLETION. THIS PERMI'i MAY BL <br />CANCELLED BY THE CITY UPON :.�Y S70PPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS �URPTION. <br />