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TYPE OR PRINT ONLY <br />Owner <br />lication Por <br />PUBLIC VvJRKS PERMlT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98207 259-8810 <br />Applicant Mai <br />Describe Proposed Work <br />PROJECT ADDRESS (if known) <br />Date <br />Public Works Permit M <br />Building Perr.iit p_ <br />Public Works Fes $ _ <br />Plan Check No: C 509'6 SEPH <br />Applicat.Date: 02/21j96 <br />Job Address: 4018 HOYT AVE <br />Owner: HENDRICKS �IOHN <br />Tenant: <br />Propoeed Use: SINGLE FAMTLY RESIDENCE <br />Desc. of Work: <br />REMODEL <br />OFFICE SET JOB SET <br />APPROVED FOR PERMIT: DATE_/_/_ BY <br />Fhane .o. <br />Attach four (4) copies of plans for pmposed work - Draw to scale and note Ihe following if applica6le: <br />•Property Lines •Outline and dimensions of all ezisting and pmposed stmctures on lhe lot •6cisting and proposed utilities <br />•Centerline o( street •Indicate Norih 'Show any proposed grading changes 'Show measurements <br />PERMIT C�NDITIONS: <br />1. AII calls for inspection shall be made 24 hours in advance - phone 259-8810. <br />2. All work shall be performed 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 NUMBER 1-800-424-5555. <br />=UAL1(: WORKS PEPnSi' <br />t;�7 EpUIRE� <br />� y--=�'� — <br />♦nTE. z��� --- <br />Approved for Constmction Date <br />FINAL INSPECTION Date <br />Approved as Constmcled <br />W <br />� <br />� <br />� <br />■� <br />� <br />�♦^ <br />V� <br />� <br />a <br />ACKNOWLEDGEMENT OF CONDIT10N5 <br />The undersigned ownedapplicant hereby agrees to hold and save harmless <br />ihe City of Everett from any and al; claims tor damages, costs, expenses, or <br />causes of action that may arise because of installation and maintenance of <br />the improvement or other right-of-way use hereto applied for and futlner agrees <br />to remove same upon notice from the City and to replace pubtic pmperty <br />damaged thereby. <br />Signawre of Applicant Dato <br />WORK AUTHORIZED BY THIS PERMIT MUST 6E STARTED WITIiIN 180 DAYS OF DATE PERMIT IS ISSUED AND TIIEREAFfER IS TO BE DILIGENTLY PURSUED TO <br />COMPLEfION. THIS PERMIT MAY 8E CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />