Laserfiche WebLink
Date <br />�. <br />Application For <br />PUBL.I� Vi/ORKS PERFiAIT <br />Print or Type Only <br />Plan Check No: B 41166 �F:PA <br />Owner Applicat.Date: 06/30/93 <br />Job Addre�s: 36b5 LOMBARD <br />Owner: BERG BILL <br />Tenant: <br />Proposed Use: SINGLE FAMILY RESIDENCE <br />Applicant Desc, of Work: <br />750SF BLOCK FOUNDATZON <br />Describe Proposed Work _ OFi�'ICE SET JOB SET <br />APPROVED FOR PERMIT: DATE_/_/ <br />Project Address (if known) <br />BY <br />PUEIIc Worke Parmtl s <br />BItl9. Dept. y _ <br />Publi[ WorW Fee <br />TalalFea S <br />Lesa Appl Fee Paid S <br />Celance D�e $ <br />p Phone <br />Attach four (4) copios of plans for proposed work - Draw to scale and note the following as applicable: <br />• Property Lines • Centerline of street <br />• Outtine and dimensions of all existing and • Indicate North <br />proposed structures on the lot � • Show any propoced grading changes <br />• E:cisting and proposed utilities • Show measurements <br />Phone <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 fn accordance wlth this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />:t. Call Locauu�� Underground Service 4B lirs, before you dig. TOLL FREE NUMBER 1-800•424•5555. <br />PUBLIC WURKS PERMIT <br />NOT fiEQUIRED <br />BY �' � <br />DATE �'' �" % j <br />Approved lor Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />PUBLIC WOFiKS DEPARTMENT <br />3200 Cedar Street . <br />Everett, WA 98207 <br />Phone:259�8810 <br />ACI<NOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />� <br />� <br />O <br />The undersigned owner/applicant hereby agrees to hcld and save harm• <br />less the City of Everett Irom any and all claims for damages, costs, <br />ezpenses, or causes of action that may arise because of inslallation <br />and maintenance of lhe improvement or other rigtit-of•way use hereto <br />applied for and further agrees to remove same upon notice Irom the <br />City and to replace public property damaged thereby. <br />Signature ol Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STAR�fED WITHIN <br />180 DAYS OF DATE PEqMIT IS ISSUED AND THERFAFTER IS .TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />