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EWz-**a3 <br />For <br />PUBLIC WORKS PERMIT <br />TYPE OR PRINT ONLY <br />Owner <br />Applicant <br />Describe Proposed Work _ <br />PROJECT ADDRESS (if known) <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 259-8810 <br />Plan Check No: C 59959 <br />Applicat.Date: 08/19/98 <br />Job Address: 801 LAUREL DR <br />Owner: BRACRIN BILL <br />Date• <br />Public Works Permit N _ <br />Builaing Permit if <br />Public Works Fee $ <br />SEPA <br />Phone <br />Tenant: <br />Proposed Une: SINGLE FAMILY RESIDENCE <br />Deso. of Work: <br />ADDITION/REMODEL <br />OFFICE SET_ JOB. SET <br />APPROVED FOR PERMIT: DATE_/_/_ BY <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following If applicable: <br />•Property Lines 'Outline and dimensions of all existing and proposed structures on the lot *Existing and proposed utilities <br />"Centerline of street 'Indicate North •Show any proposed grading changes •Show measurements <br />PERMIT CONDITIONS: <br />1. All 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 />Approved for Construction Date <br />FINAL INSPECTION <br />Approved as Constructed <br />Date <br />?UGLIC WORKS FERMII <br />NOT fqEQUIRE4 <br />PATE -- <br />W <br />7A, <br />z <br />O <br />O <br />an <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damages, costs, expanses, 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 further agrees <br />to remove same upon notice from the City and to replace public property <br />damaged thereby. <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br />COMPLET-ION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />