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Date a�ou�wo,ks aa,mn> <br /> Hpplicalion For e�a9.oeo� • <br /> PUBLIC WORKS P�RMIT PUOTotalFeeFea a <br /> lea AoO�Fee PaiE $_ <br /> Print or Type Only Plan Check No: C 46263 SEPA eaia��ao�e S <br /> Applicat.Date: 11/21/94 <br /> Job Addresa: 3219 KROMER AVE <br /> Owner: HA2EN DON/MARCIA <br /> Tenant: <br /> Proposed Use: SINGLE FAMILY RESIDENCE <br /> Owner Deac. of Work: �,p Phone � <br /> HOUSE REMODEL WITH ADDITION Oe GARAGE <br /> Applicant - OFFICE SET JOB SE.T ip Phone <br /> APPROVED FOR PERMIT: DATE_/_/_ BY <br /> Describe Proposed Work _ <br /> W <br /> Project Address�if known) _ � <br /> ktach four(4) copies of plans for proposed work- Draw to scale and note the lollowing as applicable: i <br /> • Property Lines • Centerline ot sireet � <br /> • Outline and dimensions of all existing and • Indicate North <br /> proposed structures on ihe lol • Show any proposed grading changes <br /> • Exisfing and proposed utilities • Show measuremenis � <br /> r DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDIT�ONS � <br /> t.All calls lor inspection shall be made 24 hrs.in advance-phone 259•8810. � <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br /> Standards and Specifications. <br /> 3.Cali location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> O <br /> � <br /> 'UBIIC WORKS PERMIT � <br /> hOi REQUIREII <br /> :Y ��7/ l. O <br /> ATE_ ///�;/�5'=— A <br /> bj. <br /> ACKNOWLEDGEMENT OF CONUITIONS <br /> The undersigned owner/applicanl hereby egrees to hold and save harm� <br /> less Ihe City of Everett Irom any and all claims lor damages, costs. <br /> expenses, or causes of action Ihat may arise because of installation <br /> and maintenance of the improvemen� or other righFol-way use hereto <br /> applied for and lurther a9rees to remove same upon nolice Irom the <br /> Approved lor Construction Date City and lo replace pu6iic property damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constiucted Signature of Applicant Date <br /> �Ar��/ PUBLIC WORKS DEPARTMENT WOF;K AUTHORIZED BY THIS PER�AIT MUST BE STARTED WITHIN <br /> � 180 UAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO '� <br /> 3200CedarSlreet BE DILIGENTLY PURSUEU TO COMPLETION. THIS PERMIT MAY B[ <br /> Everett,WA 88201 CANCELLED 8Y THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone;259�8910 PROJFCT OVER 90 DAYS DURATION. <br /> �r ' <br />