6407 LOMBARD AVE 2016-01-01 MF Import

Date 12/19/94 Application For PUBLIC WORKS PERMIT Print or Type Only PuOLc Worxs Permi� • _ ema. oeat . 46 SO 1 PubLc Works Fee Totalfee � Less Pppt Fes �a�tl S Aalanre Due $ Thumas Idebb 6407 Lombard �verett 98203 353-0688 Owner Mailing Address City Zip Phone Same Applicant Describe Proposed Work Project Address (if known) Address City Bedroom Addition 6407 Lombard Ave Zip Phone Attach four (4) copies ot plans for proposed work - Draw to scale and note the tollowing as applicable: � property Lines • Outline and dimensions ol ...I existing and proposed siructures on the lot • Exisling and proposed ut�lities • Centerline of street • Indicate North • Show any proposed grading changes • Show measurements PERM�T CONDITIONS 1. All calis tor inspection shall be made 24 hrs. in advance • phone 259•8810. 2. All work shall be pertormed in accordance with this p2rmit and current Ciry of EvereU Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424•��55. 'UBLIC WORKS PERMIT haf REQUIREf� ?Y •.�ATE t� "�- Approved lor Construdion Date PINAL INSPECTION Approved as Construcfed PUBLIC WORKS DEPARTMENT � � 3200 Cedar Street Everett, WA 98201 Phone:259-BB10 ACKNOWLEDGEMENT OF CONDITIONS �w _ / O a The undersigned owner/applicant hereby agr2es to hold and save harm� less lhe City ol E-�;erett from ary and all claims �or damages, costs. expenses, or causes of action that may arise because of installation and maintenance Of lhe improvement Or other righl-ol-way use hereto applied for and furiher agrees to remove same upon notice from the City and to replace public property damaged thereby. Dale Date Signature ol ApPlican: WORK AUTf10R12ED BY Tf115 PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND TIIEREAFTER IS TO BE DILIGENtLV PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATiON.