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� ^Nkatlon For . <br /> PUBLIC 1►.JRKS PERMIT °e,e— <br /> PUBLIC WORKS DEPARTMENT �Publlc Works Pertnit N <br /> 3200 Cedar Street <br /> Everett,WA 98201 259-8810 Building Pertn%M <br /> TYPE OR PRINT ONLY Public works Fee E <br /> Owner Mailin Plan Check No: C 51619 SEPA Phone <br /> Applicat.Date: OS/03/96 <br /> Job Address: 12b1 GRAND AVE � � <br /> Owner: HASCAL AL <br /> Appl(cant Meillr Tenant: Phane <br /> Propoaed 'Jee: SINGLE FAMILY RESIDENCE <br /> Deec. of Work: <br /> UTIL. ROOM/BATHROOM ADDITION <br /> Describe Proposed Work ■ . ■ <br /> OFFICE SET JOB SET � <br /> APpROVED FOR PERMIT: DATE <br /> _�_�� BY — <br /> r� <br /> PROJECT ADDRESS(f known) � <br /> Attech four(4)copies o1 plans for pioposed work-Draw to scate and note the following if applkede: <br /> 'Roperty Lines 'Outline end dlmensions of all existing and proposed struclures on the lot •Fxisttng end proposed utilitles O- <br /> `Centerline of stiaet •Indleete North 5how eny proposed grading changas 5how measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: � <br /> i: ,e. � 1.All calls for inspection shall be made 24 hours in advance- phone 259-8810. O <br /> �'� � , 2.All work shall be performed in accordance with this permit and curcent 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 /> ' v♦ <br /> O <br /> �U9lIC YuORNS PEplyll' a <br /> �O r 9EQUIRED <br /> �Y—�. <br /> MATE__` G 9F <br /> � --'--- <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harmless <br /> tha Ciry ot Everett hom any and all claims for damages,costs,axpanses,or <br /> Approved lor Constmetlon Date causes��f ection that mey arise beceuse of installatbn and maintenence ot <br /> the Imnrovement a other right-oi-way use herato applled 1w and further agiees <br /> to reinove same upon notke hom the CNy and to replace public pmpeAy <br /> damaged thereby. <br /> FINAL INSPECTION Data <br /> Approved as Constructed <br /> Signature of Applicam Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLE'TION.THIS PERMR MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PRQIECT OVER 90 DAYS DURATION. <br />