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Date <br />Application For <br />PUQLIC WORKS PERMIT <br />Print or Type Oniy <br />Plan Check No: B 39612 <br />Applicat.Date: 02/18/93 SEPA <br />Owner Job Address: 907 HOYT AVE <br />Owner: LEGROS JACK <br />ProposednUse� SINGLE FAMILy RESIDENCE <br />Applicant Desc. of Work: <br />FIRE DAMpGE–RGBUILD GARAGE & SHEETROCK <br />SMOKE DAMAGED HOUSE <br />Describe Proposed Work Of'FICE SET <br />�,u�ec� qdtlress (il known) <br />SET <br />APPROVED FUR PER7.fZT; DATE <br />_�_�_ k3Y <br />Pwi,c worvs pe�m�i s <br />eiag. Oem � _ <br />PuCL� Warns Feo <br />To;ai Fert $ i- <br />�es�/Opl Fee Paitl S -- <br />Balan�o0ue $ <br />zip Phone <br />�] <br />Attach four (4) cepies ol plans for proposed werk - Draw to scale and note the lo s applicable: <br />• Property Lines <br />• Outline and dimensions nt all existing and <br />proposed structures on the lot <br />• Existing and proposed utilities <br />• Centerline of streel <br />• Indicate North <br />• Show any proposed grading changes <br />• Show measurements <br />PERMITCONDITIONS � <br />1. Ali Calls for inspeCtion Shall be made 24 hrs. in advanCe- phone 2$y$$�Q. <br />2. Ail work shall be pertormed in accordance with this permit and curren; City of Everett Design and Consiruction <br />�tandards and Specifications. <br />3. Call �ocation Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-„00•424•5555. <br />'UBLIC WORKS PERM17 <br />NOT qEpU1REp <br />8Y i�, <br />DATE 2- � Z � , <br />/� <br />AFProved for Construction —�� <br />Dale <br />FINAL INSPECTION <br />Approved as Constructed Dale <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone:259�8010 <br />AC�:NOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to holtl and save harm- <br />less the City o' Everetl Irom any and all claim=. for damages, costs, <br />expenses, or causes of action !hat may arise because of installatiun <br />and maintenznce of the improvement or other nght-ohway use hereto <br />applied for acd further agrees lo remo� a same upon notice Irom thc <br />City and to replace public property damaged thereby. <br />Signature ol Applicant <br />WORK AUTHORIZED BY THIS PEFlMIT MUST BE STARTE� WITF!I�J <br />1f30 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BF DILIGENTLY PURS1IED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DUR4710N. <br />