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Date <br />Applicallot, . or <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Owner <br />Applicant <br />Describe Proposed Work <br />Project Address (if known) <br />Plan Check No: C 40768 SEPA <br />Applicat.Date: 05/28/93 <br />Job Address: 58229 OAKES AVE <br />Owner: DICKERMAN DAVID <br />Tenant: <br />Proposed Use: SINGLE FAMILY RESIDENCE <br />Desc. of Work: <br />HOUSE ADDN W/REMODEL <br />OFFICE SET JOB SET <br />APPROVED FOR PERMIT: DATE_/_/_ BY <br />PuMb Wodu Permit e <br />Bldg. Deft <br />r0k Woft Fee <br />Total FM i <br />Lose Awl. FN Peld i <br />Wilmot Due <br />Zip Phone <br />Zip Phone <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: <br />• Property Lines. <br />• Centerline of street <br />• Outline and dimensions of all existing and <br />• Indicate North. <br />proposed structures on the lot <br />• Show any proposed grading changes <br />• Existing and proposed utilities <br />• Show measurements <br />PERMIT CONDITIONS <br />1, All caps for Inspection shall be made 24 hrs. In advance - phone 259-8810. <br />2. Ail work shag be performed In accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3 Call Location Underground Service 48 hra before you dig. TOLL FREE NUMBER 1.800-424.5555. <br />PUBLIC WORKS PERMIT <br />NOT REQUIRED <br />BV <br />CL <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Coder Street <br />Everett, WA 98201 <br />Phone: 259-8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />z <br />0 <br />0 <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City of Everett from any and all claims for damage% costs, <br />expenses, or causes of action that may arise because of Installation <br />and maintenance of the Improvement or other right -of -Way use hereto <br />applied for and further agrees to remove same upon notice from the <br />City and to replace public property damaged thereby. <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />