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., , � ., . ,,, <br /> ' � PUBL�C WORKS °p�;����°°� � � <br /> Date <br /> Public Works Permit d W0109-010 <br /> PERMIT BuildingPemiitq C0109-008 <br /> PUBLIC WORKS DEPARTMENT Planning Relerence M <br /> 3200 Cedar Street <br /> Everett,WA 98201 Public Works Fee 5 $25 . Q� <br /> (425)257-8810 <br /> �n .MN 01 Zp2 Guarantee$ <br /> OWNFR NA AUGHN r�ISTOPHER & LAURA APPLICANT NAME <br /> ANDADDRES � ANDADDRESS: <br /> 221 LOMBARD AVE <br /> E:VERETT WA 98201 <br /> PHONE: PHONE: <br /> TAX PARCEL I.D.a PROJECTAODRESSf' " <br /> DESCRIPTIONOF�EDROOM / BATH ADDITION <br /> PROFOSED WpR : <br /> PW <br /> PERMIT CONDIT�ONS <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 City of Everelt Design and Censlruction <br /> Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-q24-5555 <br /> 4 . UPGRADE SIDE SEWER (PLUMBING ITEM) W <br /> 5 . DOWNSPOUTS MUST BE CONDTECTED TO SIDE SEl�IER � <br /> V+ <br /> 09-24-01 4:08FH � <br /> � 109008 O <br /> 6UILD 3Y1.25 <br /> SkCHG 4.50 � <br /> DRIVE 25.00 <br /> FLUHS 28,00 Z <br /> t!ECH 14.00 O <br /> TOTAL 462.75 <br /> CIiEK 4f�!Ti <br /> A Ohf4821 � <br /> � <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> � G,�� 9 �a �� The undersigned owner/applicam hereby agrees to hold and <br /> save harmless the Ciry of Everett irom any and all claims for <br /> p oved lor Cons�rLciion /� Date damages,wsts,expenses,or causes of action that may arise <br /> � because of installation and maintenance of the improvement or <br /> .,i.�,.�-----�/! Z� U other right-of•way use hereto applied lor and further agrees to <br /> remove same upon no)iceirom Ihe City and b replace public <br /> FINAL INSPECTION i <br /> property damaged Ih fGOy. <br /> �ppmvetl as Constructed Date <br /> � �/ <br /> �C/i �i��—�/C//� <br /> Signalure ol Applicant Data <br /> WORK AUTHORIZED BV THIS PERMIT MUST BE STARTED WITHIN 1B0 OAYS qF DATE PERMIT IS ISSUED ANU;HEREAF7Efi IS TO�E DILIGENTLV PURSUED <br /> TO COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANV STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />