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.tion Fa � � <br /> ���� PUBLIC W �RKS PERMlT Dete_ <br /> PUBLIC WORKS DEPAqTMENT Pubik Works Permit N <br /> 3200 Cedar Street <br /> Evaretl,WA 9820� 259-BB10 Building Pertnit N <br /> TYPE OR PRINT ONLY public Works Fee S <br /> Plan Check No: C 57155 SEPA , <br /> �ef Applicat.Date: 11/17/97 <br /> 3ob Addreee: 14i0 GRAND AVfi Phone <br /> Owner: JACOBSON ROBERTA <br /> Tenant: <br /> Iicant Ptopoeed Uae: SINGLE FAMILY RESIDENCfi <br /> � Deec. of Work: Phona <br /> ADDITION AND REMODEL <br /> Describe Proposed Work _ ■ ■ ■ <br /> OFFICE SET JOB SET — W <br /> APPROVED FOR PERMIT: DATE_/_/_ BY � <br /> �� <br /> _/ <br /> PROJECT ADDRESS(if known) � <br /> itlach lour(4)eopMs oi plans lor proposed work•Draw to scele and rrote the following if applicable: O <br /> 'Proparty Lfnes 'Outllne and dimensions of all nxfsting and proposed structuras on the lot •Existiny and proposed utilkies <br /> 'Centerline ol straet •Indieate North 'Show any proposed grading chenges •Show measumments <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: � <br /> 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 current City of Everett Design and <br /> Construction Standards and Specificatfons. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> � <br /> !'UCLIC WORKS �EpM�r O <br /> 1fO`t��1R, EUUIRE� � <br /> !Y.__L'_�. <br /> �ATC.�__,..:� �-� �_ <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> � The undersigned owner/applieant Mreby ayrees to hold and aavs h�rtnhay <br /> the City ot Everett hom any and all claims fu damagsy,ewts,expanaas,w <br /> i Approved for Construction Date causes of aclion that may arise bxause of Inatsllatbn and malntenanca of <br /> the impmvement a other right-of-way use herMo applbd la and hrttMr aprsea <br /> to remova same upon ratice hom tM CHy end to replsee pudb piopaty <br /> demagad thereby. <br /> FINAL INSPECTION Date <br /> IApproved as Constructed <br /> Slgnature of AppNcant D�t� <br /> �NORK AUTHORRED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMR IS ISSUED AND THEREAFfER IS TO BE DILIGEA'TLY PURSUED TO <br /> COMPLEf10N.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATqN. <br />