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� <br />TYPE OR PRINT ONLY <br />^ �lication For <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS OEPARTMENT <br />3200 Cedar Streat <br />Everett, WA 98201 259-8810 <br />Date <br />Public Works Permit k __ <br />Building Permit q _._ <br />Public Works Fee $ __ <br />Plan Check No: 8 527':4 SEPA <br />— Applicat.Date: 09 04/96 <br />Owner Job Addre: 120 MADRONA AVE <br />Owner: PACI(E.</GRAMLItdG <br />Tenant: <br />Applicant <br />Describe Proposed Work _ <br />FROJECT ADDRESS (if known) <br />Propoaed Use: SINGLE FT�MILY RESIDEN,. <br />Desc.. of Work: <br />DECK ADDN AND INTERIOR REMODEL <br />OFFICE SET JOB SET <br />APPRVD FOR PBRMIT: DATE_/_�_ BY <br />Phone <br />Phone <br />A:tacl� four (4) copies of plans for �ioposetl work • Draw to scaie and note ihe following if applicable: <br />•Property Lines 'Outline and dimansions of all existing and proposed structures on the lot •Existing and proposed utilities <br />'Centeriine of sireet •Indicate Norih •Show any proposed greding changes •Show measuremenis <br />PERMIT CONDITIONS: <br />1. All calis for inspection shall be made 24 h=•�rs in advance - phone 259-8810. <br />2. All work shall be pertormed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMHER 1-800-4�4-5555. <br />IJ a 4�.�(�z Ulol� (�-s I��K., i�F lZcg. <br />��. ��- <br />Approved for Construction Date <br />FINA� INSPECTION Date <br />Approved as Consinictad <br />� <br />� <br />��/� <br />V♦ <br />O <br />a <br />ACKNOWL�DGEMENT OF CONDITIONS <br />The undersigned ownedapplicant hereby agrees to holC and save hartnless <br />the City of Everett from any and all claims for tlamages, cosis, ezpenses, or <br />causes of actlon that may arise because of installation and maintenance of <br />ihe impmvement or other right-of-way use hereto applied for ar�d lunher agrees <br />to remove same upon notice from Ihe City zntl to replace public pmperty <br />damaged thereby. <br />Signat�re of Applicant Date <br />WORK AUTHORIZED 6Y THIS PFRMIT MUST BE STARTED WITHIN 790 JAYS OF UATE PEpM1T IS ISSUED AND TF'> qEAFTER IS TO BE DILI9ENTLV PURSUED TO <br />COMPLEiiON. THIS PERMIT MAY BE CANCELLED BY THE CITV UPf.i �:1NY STOPPAGE OF WORK ON THIS PRO�ECT OVER 9U DAYS DURATION. <br />