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C„ppncatbn For DBte 4 <br /> PUBLIC WORKS PERMIT <br /> Public Works Pertnit# <br /> PUBLIC WORKS DEPARTMENT <br /> 3200 Cedar Street <br /> Everett,WA 98201 (425)257-8810 Building Pertnit N <br /> TYPE OR PRINT ONLY Public Works Fee$ <br /> Plan Check Nos C 62689 SEPA <br /> Owner A pLicat.Data: 06/08/99 Phone <br /> PJob Addreaa: 6422 ELLIOTT WAY <br /> Owner: WIEDNER / MICHAEL <br /> Appifcant Tenant: Phone <br /> Propoeed Uee: DUPLEX <br /> Deec. of work: <br /> Describe Proposed Work ^ ExTENo 15T FLOOR AND ADD 2ND FLOOR I � I <br /> W <br /> OFFICE SET JOB SET H <br /> APPROVED FOR PEAMIT: DATE_/_/._ BY � <br /> � <br /> PRWECTADDRESS (if knawn) li� <br /> Attech four(4)copies plens for proposed work•Drew to sceie and note the lollowing if appllcabie: O <br /> •Property Llnas •Outline and dimensions ol ell exist(ng and proposed structures on the let •Existing and proposad utiliNes � <br /> •Cente�fine ol street •Indicate North •Show any propossd g2ding 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 permit and current Ciry of Everett Design and � <br /> Construction Standards and Specifications. , <br /> 3. Call Location Uncarground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. //► <br /> V♦ <br /> �'iJDLIC WORKg O <br /> AOT '�RMI i <br /> OUIqEp� � <br /> ty <br /> �ATE--- �!/. � `_ <br /> � '—----_ <br /> ACKNOWLEDGEMENTOFCONDITIONS • <br /> The undersigned owner/applicent hereby agrees to hold and save hartnless <br /> the City ol Everett from any and all claims for damages,costs,ezpenses,ar <br /> pprove or ons ruc ion a e causes of actlon that may arise because of installation and maintenance of the <br /> improvement or other right�of•wa�use hereto applied lor and further agrees to <br /> remove same upon notica from the City and to replace public properry dam- <br /> aged thereby. �� <br /> FINAL INSPECTION Date <br /> Approvad as Constructed <br /> �igna ure o pp ican a e <br /> VVOFiKAUi}10R�D BY iHIS PERMR MUST BE STARTED Wfh11N 1B0 DAYS OF DATE PERMfT IS ISSUEDAND TFiEFiEAFTER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLEiION.THIS PERMR MAY BE CANCELLED BY TI1E CfTY UPON ANY STOPPAGE OF WOFiK ON TMS PRQECTOVER 90 DAYS WRATION. <br />