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Applicabon For / <br /> �i��� PUBLiC WORKS PER�VIIT oate_ 4-18-97 <br /> PUBLIC W07K5 DEPARTMENT Public Works Pertnit# __q�'_/�3� <br /> 3200 Cedar Street � <br /> Everetl,WA 98201 259-8810 Building Permit# 54882 <br /> TYPEOflPRINTONLY T�� pQSTING ���✓ -D� PuhlicWorksFeeS_GdO� <br /> Mary Jane Bur.ton 7110 Jefferson Ave Everett 98203 347-1533 <br /> Owner Mailing Address City Zip Phom� <br /> Pro Finish Construction Bob Gordon 348-6112 <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work house addn with new attached ara e � <br /> 1"� <br /> � <br /> V♦ <br /> PROJECTADDRESS (if known) 7110 Jefferson Ave � <br /> Attach four(4)copies of plans for proposed work-Dmw to scale and note the tollowing if applicable: <br /> •PropeAy Lines •Outline and dimensions of all existing and proposed strucWres on the lot •Existing and proposed ulililies O <br /> •Centedine of streM "Indicate Norih •Sho.v any proposed grading changes •Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: � <br /> 1. All calls for inspection shall be made 24 hours in advance - phore 259-8810. o <br /> 2. All work shall be performed in accordance with this permit and current City of[verett 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 /> V♦ <br /> O <br /> a <br /> 06-05-97 9:02Aii <br /> tl 54B82 <br /> EUILDING �?4.50 <br /> FL.UHBII�'i 42.00 <br /> MECHANICAL 15.00 <br /> SI�CHRRGE 4.5^ <br /> [�IVEUAY 20.00 <br /> FLAN CHECK 42.71 <br /> TOTRL 648.71 <br /> CHEK 648.71 <br /> A OR �3B <br /> ^ ) ACKNOV/LED�3EMENT OF CON�ITIONS <br /> -�.�' -� The undersigned owner/applica�l hereby agrees to hold and save harmless <br /> ��v� the City of Everett from any anU all claims for damages,costs,expenses,or <br /> �ovetl for n ction Date causes of action that may arise 6ecause of ins;�tlation and maintenance ol <br /> the improvement or other right-ol-wvay use hereto appfi;d!„r a�:d furiher agrees <br /> �,'��/� /7� / to remove same upon notice lrom ihe City and to replace pw�lic propeRy <br /> e(�G:-- u ���(� - �S damage reby. <br /> FINAL INSPECTION Date <br /> Approved as Conslructed <br /> �'-S l7 <br /> ignatureofApplica pr — <br /> WORK AUTHORIZED�Y THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEFEAFI'ER IS TO BE DILIGL'NTLY PURSI�� <br /> COMPLEfION.THIS PERMIT MAY BE CANCELL=D BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PFiOJECT OVER 90 DAYS DURATION. <br />