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�at@ PuElic Worhs Permit• <br /> Applicatlon For 8�a0�0epts <br /> PUBLIC WORiCS PERMIT P�°T018FeeFee s <br /> �eas noo�Fea Paie 3 <br /> 8alante Due S <br /> Print or Type Only <br /> Owner Plan Check No: B 44156 SEPA Phone . <br /> 71pp1icat.Date: 04/19/94 • <br /> . Job Addreas: 104 MAGNOLIA <br /> Owner: BROWN TIM <br /> Applicant Tenant: <br /> Proposed Use: SINGLE FAMILY RESIDENCE Phane <br /> De�c. of Work: <br /> ADDITION TO EXISTiNG FAMILY ROOM <br /> Describe Proposed Work _ <br /> OFFICE SET JOB SET <br /> APPROVED FOR PERMIT: DATE_/_/_ BY <br /> W <br /> Prolect Address(if known) � <br /> Attach lour(4)copies ol plans tor proposed work•�raw to scale and note the lollowing as applicable: i <br /> • Property Lines • Centerline of street /� <br /> • Outline and dimensions of all existing and • indicale North V, <br /> propo5ed siructures on the�ot • Show any proposed qrading changes <br /> • Existing and proposed utilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All calls for inspection shall be made 24 hrs.in advance•phone 259•8810. � <br /> 2.All work shall be peAormed In accordance with this permit and current City of Everett Deslgn and Consiruction <br /> Standards and Specificntions. <br /> 3.Call Localion Underpround Service a8 hrs.before you dig.TOLL FREE IJUMBER 1•800-424-5555. � <br /> O <br /> PUBLIC VJORKS PERMIT � <br /> NOT pUIRED <br /> BY � <br /> DATE � � 9� — O <br /> � <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm• <br /> less Ihe Cily of Everelt Irom any snd all claims lor damages. costs. <br /> expenses, or causes ol action Ihal may ari,e because ol inslallation <br /> and mainlenance of the improvement or other righDul�way use hereto <br /> apPlied for and furiher agrees te remove same upon notice from the <br /> Appwved tor Construction Date Cily and to replace pubhc property damaged ihereby. <br /> FINAL INSPECTION Dale __ <br /> Approved as Constructe,'�. S;ynature ol Applica�d Dale <br /> PU6LIC WORK:f'EPARTMENT WORK AUTHORIZE� BY THIS PERMIT t�1UST BE STARTED WITHIN <br /> 3200Ce.dar5��aet 1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION.TFIIS PERMIT MAY BE <br /> Phone:259�BB10 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PRf1JFCT OVFR 90 DAYS DURATION. <br />