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Data <br />-. <br />Application For <br />PUBLIC WORKS PERMIT <br />Prmt or Type Only <br />Owner <br />Applicant <br />Describe Proposed Work <br />Prolect Address (if known) <br />�. <br />Plan Check No: C 48518 SEPA <br />Applicat.Da'.e: 06/06/95 <br />Job Addresa: 5631 EAST DR <br />Owner: MCILAANEY DON <br />Tenant: <br />Proposed Use: SINGLE FAMILY RESIDENCE <br />Desc. of Work: <br />ADD BEDROOM IN BACK AND 8' ACROSS FRONT <br />OFFICE SET JOB SET <br />APPROVED FOR PERMIT: DATE_/_/_ BY <br />_ _ . ..... _ <br />Publle Warkt Pe�mll • <br />BIO¢ OeD� � _ <br />PuElic wo�ks Fee s <br />Total Fee <br />Leaa Appl Fee PaiO S <br />Balance D�e S <br />Attach four (4) copies of plans for proposed work • Draw lo scale and note the lollowing as applicabte: <br />• Property lines • Centerline of street <br />• Outline and dimensions ol all existing and • Indicate North <br />proposed structures on the lot • Show any proposed grading changes <br />• Existing and proposed utilities • Shuw measurements <br />LI <br />Phone <br />Phone <br />PERMIT CONDITIONS <br />1. All calls for Inspection shell be made 24 hrs. in advance - phone 259•8810. <br />2. All work shall be pertormed in accorda^ce with this permit and current City of Everett Design and Constructton <br />Stendards and Specifications. <br />3. Call Location Underground Service 48 hrs. beFore you dig. TOLL FREE NUMBEH 1•800-424•5555. <br />/v0 /��%7 ��o�'���� (j j� � <br />Co <br />�� LC � �f ���/��'i� �✓,`// � �,'/f d�.�P� �X�3�� <br />�S: _�� �c..�er— � �r E: �� v-� �/�e s: �e <br />�,� �,� �� �r� �� %��,� �s f � <br />UP y�e�� -fo •�� -� <br />Approved for Conslruction <br />Date <br />FINAL INSPEC710N Dale <br />Approved as Constructed <br />�A`If i� PUBLIC WORKS DEPARTMEN�i <br />3200 Cedar Street <br />Fd Everelt, WA 98201 <br />Phone: 259-8810 <br />W <br />H <br />— / <br />� z <br />1 O <br />♦�^ <br />V! <br />O <br />a <br />ACKNOWLEDGEMENT OF COND�TIONS <br />The undersignetl owner/applicant hereby agrees to ho�d antl save harm- <br />less ihe City ol Everetl Irom any and all claims for damages, costs, <br />erpenses, or causes of aclion Ihat may arise because of installation <br />and mainlenance of ihe improvement or other dghl-of�way use herelo <br />applied for and turther agrees to remove same upon r.otice Irom the <br />Ci;y and to replace public properly damaged thereby. <br />Signature ol Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST C11: STARTED WITHIN <br />180 DAYS OF DATE PEliMIT IS ISSUED AND 'I I I1: REAFTER IS �TO <br />BE DILIGENTLY �URSUED TO COMPLETION. TI II't I�I qMiT MAY BE <br />CANCELLED BY THE CITY UPON �NY STOPPAGI '� �� "•'�>RK ON THIS <br />FROJECT OV[R 90 DAYS DURATION. <br />