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F« <br />PUBLIC W&KS PERMIT Daft <br />OR PRINT ONLY <br />Describe Proposed Work _ <br />PROJECT ADDRESS Of known) <br />PUBLIC woRKs OEFYVt1►AFTT <br />71Se Ga. Sheet <br />Ewaa,MfAti M EiFrM10 <br />Pulft We Pwme * <br />[.7'-'7' .„TI <br />Pubic V tato Fees <br />Plan check Not c S8919 SEPA <br />pJobcAdre21272 i80AVE Phan <br />Adss Owner: SEDY KATHY <br />Tenantt <br />Proposed Des: SINGLE FAMILY RESIDENCE» <br />Daao. W <br />o <br />rk: <br />ADDITI0IO 1f <br />OFFICE SET JOB SET <br />APPROVED FOR PERMIT: DATE_/_/_ BY <br />Attach four (4) copies of plans for propoeed wok - M" to scat and note the loaowYq It oppNa6N: <br />-Property Unu aOutAn* and dirrrnebrw of all sxW*V and proposed stratum on the M eEais*q and propoeW uOdu <br />mCamerlka of street `Indicate North 'Show arty l; n p - d fla& d>anM 'Show msuuemenb <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 1-800-424-6588. <br />VUBLIS WORKS ptiRAlli <br />NOT R�,QUIR@41 <br />iY.____---{ram_-, <br />RATE '' <br />Approved for Construction Date <br />FINAL INSPECTION Data <br />Approved as Constructed <br />TT <br />7 <br />co <br />0 <br />z <br />0 <br />0 <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned ownahpplIcant 10" spree to hold and ewe herniae <br />the City of Everett km any and M claim nor drape, coats, spine, or <br />causes of action that may miss becau** at YatWtion and rtnaYnlrwtoa d <br />the Inproawnerdorottere#*-d-wayuehm appledforandhadaregree <br />to remove one upon notice kom the City and to replace Pubs praparty <br />damped thereby. <br />Signature of Applicant Oat* <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 100 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CRY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />