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� �Plication FM <br /> PUBLIC WORKS PERMIT Date <br /> PUBUC WORKS DEPARTMENT Public Works Pertnit M <br /> 3200 Cedar Street <br /> Everett,WA 98201 259-8810 Building pertnit M <br /> TfPE OR PRINT ONLY ^ " "' �ks Fee S <br /> Plan Check No: B 52545 SEPA <br /> Appliaat.Date: 08 09/96 <br /> . 3ob Addrese: 21 4 GRAND AVE <br /> Owner Owner: JONES JEFFREY T Phone <br /> Tenant: <br /> Proposed Uee: SINGLE FAMILY RESIDENCE <br /> Deec. of Work: <br /> Applicant FOUNDATION FC�F. EXISTING HOUSE Phone <br /> Describe Proposed Work_ oFFice SET JOB SET <br /> APPROVED FOR PERMITi DATE_/_/_ BY W <br /> � <br /> � <br /> � <br /> PROJECT ADDRESS(if known) <br /> Attach four(4)copks o1 plens for proposed wak-Draw to scale and note the folbwing if applicable: � <br /> •Property Lines �OutAne and dlmensions of all existing and proposed structures on the lot •Existing and proposed utilities O <br /> `CentMine of street 'Indicate North 5how 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• phone 259-8810. O <br /> 2. All work shall be pertormed in accordance with this permit and curnant City of Everett Design and <br /> Constructlon Standards and Specifications. <br /> • 3. Call Locatlon Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-6556. � <br /> � <br /> O <br /> � '�o (�k! Pr„r►�,.�+ ��tu� a <br /> �~ <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harmless <br /> the City of Everetl from any and all claims tor damages,costs,expenses,or <br /> Approved lor Construction Date causes of action that may arise because of installation and maintenance of <br /> the improvement or other right-of-way use hereto applied lor and further a9rees <br /> to remove same upon notice from the City and to replace public property <br /> damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed <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 /> COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJ[CT OVER 90 DAYS DURATION. <br />