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� <br />� <br />TYPE OR PRINT ONLY <br />� ���, � <br />PUBLIC 1�. JRKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everetl, WA98201 259•8810 <br />Owner Mail <br />ApPlicant <br />Describe Proposed Work <br />PROJECT ADDRESS (if known) <br />Public Nbrks Partnit M <br />Building PertnH N <br />Public Works Fee S <br />Plan Check No: C 52669 SEPA <br />Applicat.Date: 08/26/96 <br />Job Addreee: 601 OLYMPIC BLVD <br />Ownez: MILLER DAVE 6 SHELLIE <br />Tenants <br />Propoaed Uea: SINGLE FAyILY RESIDENC6 <br />Deec. of Works <br />BEDROOM/BATH ADDITION <br />OFFICE SET JOB SET <br />APPAOVED FOR PERMIT: DATE_/_�_ gy <br />Attach four (4) copies o} plans for proposed work - Draw to scale and note the following ii applicable: <br />Phone <br />?hone <br />•Property Lines 'Outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities <br />•Centerline of straet •Indicate North •Show any proposed grading chanqes 5how measurements <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 pertormed 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. b�fore you dig. TOLL FREE NUMBER 1-800-424-5555. <br />�'UBLIC 'wONKS �6qy�� <br />tlO7 RFOFI1A�If� <br />�v.� `��3,J - <br />"�TE_ �/?_7 9G _.. <br />7�� <br />Approved lor Construction Date <br />FINAL INSPECTION Dale <br />Appmved as Constructed <br />� <br />O <br />,�A <br />V♦ <br />O <br />a <br />ACKNOVJLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save hartniess <br />the City of Everett from any and all claims for damages, costs, ezpenses, a <br />causes of action that may anse because of Installation and maintenanee of <br />the improvement a other righbof-way use hereto applied for and further agrees <br />to remove same upon notice hom the City and to replace public property <br />damaged thereby. <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFiER IS TO BE DILIGENTLY PURSUED Tq <br />COMPLEfION. THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />