Laserfiche WebLink
Date <br /> � PUEI¢Works Pe�mll� <br /> AppliCa�iDn FOr eiap.Deoi.+ <br /> PU�LIC WORKS PERMIT Publ¢WarkSFae <br /> To�al Fea $ <br /> Less AOD�Fee PaiE $ <br /> Print or Type Only ea�a��,o�o s <br /> Plan Check No: C 4gzqZ <br /> Owner APPlicat.Date; OS/p3�g5 SEPA <br /> Job Address: 2308 JADE Phone <br /> Owner; LEVIN THOMpS & DARCEL <br /> ProposednUse: <br /> Applicant Desc. of Work; SZNGLE FAMILy RESIDENCE <br /> 2ND FLOOR ADDITION P.ione <br /> Describe Proposed Work OFFICE SET <br /> —JOH SET <br /> APPROVED FOR PERMIT: DATE <br /> _�__,�__ BY <br /> — �� <br /> Projecl Address(i�known) � <br /> Attach four(4) copies of plans for proposed work- Draw to scale and note the following as applicable: � <br /> i Property Lines � <br /> • Centerline of street I_ <br /> • Outline and dimensions of all existing and • Indicate North v� <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measuremenis <br /> DO NOT WRITE BELOW THiS IINE � <br /> PERMIT CONDITIONS � <br /> t.All calls for inspection shall be made 24 hrs.in advance-phone 259-8810. <br /> 2.All work shall be pertormed in accordance with this permit and wrrent City oi Everett Design and Construction � <br /> Standards and Specifications. <br /> 3.Call location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800•424-5555. <br /> Z <br /> O <br /> F- <br /> :'UBLIC WORKS PEAlJIT '^ <br /> Fi0'f REOUINEI� \/♦ <br /> LY_� � <br /> ;�TE_� . -s a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm• <br /> less ihe City of Everetl Irom any and all claim; for damages, cos�s, <br /> expenses, or causes of action that may arise bPcause of installation <br /> and maintenance ot ihe improvement or other righbobway use hereto <br /> Approved forConslruction Dale applied for and luriher agrees to remove same upon notice (rom the <br /> City and to replace public property damayed ihere6y. <br /> FINAL INSPECTION Date <br /> Approved as Constructed Signalure ol A�plicanl Date <br /> �Ar��i� PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CedarStreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PENM!7 MAY BE <br /> Phone:259�8910 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION <br />