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-. .�. <br /> �BtB PaElic Work�Pnmlt• <br /> Application For eiao.o•p�.• <br /> PUBLIC WORKS PERMIT °�°To:FeaF�� : <br /> �au eoo�Fo v.ia 4 <br /> Print or Type Only B�I�ncs Dua s <br /> Plan Check No: C 43042 S6PA <br /> Applicat.Data: 12 20/93 <br /> Job Address: 13 3 oARBS AVE <br /> Owners HOPRINS ERIC <br /> Owner Tf .ant� !ip Phone <br /> Propoee.. Use: SINGLE FAMILY RESIDENC6 . <br /> Deec. of Work: <br /> HATHROOM ADDN <br /> Applicant !ip Phone <br /> OFFICE SET JOB SET <br /> Oescribe Proposed WorA _ APPROVED FOR PERMIT: DATE_/_/_ BY <br /> W <br /> Prolect Address(if known) � <br /> Attach four(4)copies of plans tor proposed work- Draw to scale and note the following as appltcable: � <br /> • Property Lines • Centerline of street � <br /> • Outline end dimenelons of all existing and • Indicate North <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Ezisting and proposed utllfties • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE O � <br /> PERMIT CONDITIONS <br /> t.All calls tor fnapection ahell be made 24 nrs.in advance-phone 259�8810. � � <br /> 2.All work shell be perfurmed i�eccordence with this permit and current City of Everett Design and Construction <br /> Standarda end Speciticatlona <br /> 3.Call Location Underyround Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800�424•5555. � <br /> O <br /> PUBLIC WORKS PERMIT � <br /> NOT REpUIRED <br /> BY � <br /> DATE Z zo 93 O I <br /> a ; <br /> � <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold end save harm- <br /> less the City of Everett Irom any and all cleims tar damega4 costs, <br /> expenses, or causes of action that may arise because of instellation <br /> and maintenance of ihe improvement or other right•oi•way use hereto <br /> applied tor and further agrees to remove same upon notica Irom the <br /> Approved for Construction Date City and to replace public property damaged thareby. <br /> FINAL INSFECTION Date <br /> Approved as Construcled Signature ol Applicant Date <br /> � PUBLICWORKSDEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STAATED WITHIN <br /> 780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS �TO <br /> 3200CedarStreet B'. DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Everet4 WA 98201 C,INCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259•8810 PROJECT OVER 90 DAYS DURATION. <br />