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Date_ " ' I <br /> � Puoiic worxa Permi�a <br /> Application For aiac.o�pi: <br /> PUBLIC WORKS PERM17 �ubTolalFeeFee s — <br /> �ese aoo�Fea ve�e S <br /> Print or Type Only ee�a��a o�, s_ <br /> Owner Plan Check No: C 43531 SEPA •p Phone <br /> APJobcAdd�ress� �1196HOYT AVE � <br /> Owner: ZEH SHARON <br /> Applir.ant ProposednUse� SINGLE FAMILY RESIDENCE <br /> Desc. o` Work: P Phone <br /> SECOND FLOOR ADDN <br /> Descri6e Proposed Work _ <br /> OFFICE SET JOB SET <br /> APPROVED FOR PERMIT: DA•PE_�__�__ BY <br /> Froject Address(il known) � <br /> Attach four(4) copies of plans(or proposed work•Draw to scale and note the following as applicable: � <br /> • Property Lines � <br /> • Centedine of street I_ <br /> • Outline and dimensions of all existing and • Indicate North ;;� <br /> proposed structures on the lut • Show any proposed grading changes <br /> • Existing and proposed utilities • Show me2suremenls <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS O <br /> 1.All calls for inspection��a;;,n made 24 hrs.in advan�e•phone 259-8810. <br /> 2.All work:hall be peNormed in accordance with this permit and current City of Everett Design and Construction � <br /> Standarda and Specificatlons. <br /> 3.Call Localion Underground Service 48 hrs.before you dig.TOLL FriEE NUMBER 1-$00•424•5555. <br /> � <br /> _ �� O <br /> � <br /> � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersi9ned owner/applicant hereby agrees lo hold and save harm- <br /> less Ihe City ol Everelt irom any and all claims for damages, costs, <br /> expenses, or causes of action thal may arise because of installation <br /> 3nd maintenance of the improvement or other righbof-way use hereto <br /> Approved for Construction Date applied for and further agrees to remove same upon notice from the , <br /> Ciry and W replace public property damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Consiructetl Signature of Applicant Date <br /> ��r� PUBLIC WORKS DEPARTMENT WORK AUTHORIZEL BY THIS PERMIT MU57 BE STARTED WITHIN <br /> 3200CedarStreet 180 DAYS OF DA7E PERMIT IS ISSUED AND THEREAFTER IS TU <br /> Everett,WA g8201 BE DILIGENT�Y PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:259•BB10 CANCELLED F3'{THE CITY UPON ANY STOPPAGE CF WORK ON THIS <br /> _ PROJECT OVER 90 �AYS DURATION. <br />