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� wtion For <br /> PUBLIC VSJRKS PERMIT °a�e� <br /> PU81.!C WORKS DEPAFiTMENT Public Works Parmit M <br /> 3200 Cedar Street <br /> Everelt,WA 98201 259•8870 Building Permit N <br /> TYPE 0(i PRINT ONLY Public Nbrks Fea$ <br /> Owner � Plan Check No: C 54559 SEPA Phone <br /> Appllcat.Date: 03/19�97 <br /> Job Addreee: 49Y8 LM ST <br /> npplicant Owner: SMITH DAVID & THERESA <br /> Tenant: Phona <br /> Propoeed Uee: SINGLE FAMILY RESIDENCE <br /> Deec. of Work: <br /> Describe Proposed Work RESIDENTIAL ApDITION � <br /> OFFICE SET JOB SET � <br /> APPROVED FOR PERHIT: DATE_/_/_ BY '�^ <br /> �/ <br /> PROJECT ADDRESS(if known) � <br /> Attach lour(4)copies of plans lor proposed work-Drew to scale and note the tollowing il applicabie: <br /> •Property Lines 'Outline and dimensions of all existing and proposed structures on the iot •Existing and proposed utiliti�is O <br /> 'Centerline of street •Indicate North 5how any proposed grading changes •Show measurements � <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 this permit 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 /> V♦ <br /> � � � :� I�C. VV� �S ��rni � �J� . O <br /> ,�. a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hoid and save hartniess <br /> the City of Evarett from any and a�i claims for damages,costs,expenses,or <br /> Approved for Construction Date eauses of action that may arise because of installation and maintenance of <br /> the improvement or other right-of-way use herato applied lor and further agrees <br /> to remove same upon notice from the City and to replace public property <br /> damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed <br /> Signawre of Applicant Date <br /> WORK AUTHORIZEO BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER�S TO BE DILIGENTLY PURSUED TO <br /> COMPLETION.THIS PERMIT MAY BE CANCELIED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />