Laserfiche WebLink
Date <br />Applicalion For <br />PUBLIC VNORKS PIERMIT <br />Print or Type Only <br />Plan Check No: C 46888 SEPA <br />Oaner Applicat.Date: 02/O1/95 <br />Job A�ne�•ZBARNETTDDOROTHY J <br />Applicant <br />Describe Proposed Work <br />Tenant. <br />Proposed Use: SINGLE FAMILY RESIDENCE <br />Deec. of Work: <br />9ATH/CLOSET ADDITION <br />OFFICE SET JOB SET <br />APPRVD FOR Pi.RMIT% DATE__/_I_ BY <br />Pu01ic WorM¢ Permi� • <br />BIOp. OlD�. � � <br />Puol�c Worka Fee S <br />Total Fee <br />Less ADD� Fea 7aitl S <br />Balance Due S <br />Prolect Address (if known) <br />Attach tour (4) copies of Plans for proposed work • Draw to scale and note � Centerllre of stPae1cable: <br />• Properly Lines • Indicale Norih <br />• Outline and dimensions ol all existing and � Show any proposed grading changes <br />proposed slructures on the lot • Show measurements <br />• Existing and proposed utilities <br />Phone <br />Phone <br />pERMiT CONDITIONS <br />1. All calls tor tnspection shall h= made 24 hrs. in advance • phone :: �9•8810. <br />2. All v:ork shail be peAormed iri accordance with this permit and current �ity of Everett Design and Construcllon <br />Standards and Specifications. <br />3. Cail Localion Underground Service 40 hrs. before you dig. TOLL FREE NUMBER 1-800•424-5555. <br />�NITIAL INSPECTION <br />KIRK BROOKS <br />DAT e � `` /' '` <br />� <br />Approved for Construction Date <br />FINAL INSPECTION �ate <br />Approved as Constructed <br />�AII�9� PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everel4'NA 98207 <br />Phone:259•8810 <br />� <br />O <br />�p� <br />V♦ <br />�A <br />W <br />ACKNOWLEDGEMENT OF CONDITIONS <br />7he undersigned owner/applicant hereby agrees to hold and save harm- <br />less the Ciry ol Everett from any and all claims for damages. costs, <br />expenses, or causes of action that may arise because ot installalion <br />and mainlenance ol the improvement or olher right-ohway use hereto <br />applied for and fuAher agrees to remove same upon nntice trom thP <br />City and to replace pu6iic properry damaged thereby. <br />Daie <br />Signalure of Applicant <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DI�IGENTLY PURSUED TO C.JMPLETION. THIS PEP.MIT MAY BE <br />CAIJCELLED BY THE CITY!1POV ANY STOPPAGE CF WORK QN THIS <br />PROJECT OVER 90 UAYS DURhTION. <br />