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� PUBLIC VI��RKS PERMIT °a:0 �=— <br /> PUBIJC WORKS DEPARTMENT Public Works Pertnit M <br /> 3200 Cedar Sireet <br /> Everett,WA 98201 259•BB10 Building Permit N <br /> IYPEORPRINTONLY TO POSTING �-� s � PublieWorks=ee5 <br /> r� <br /> Owner N plan Check No: C 56Z62 SEpA �O^� <br /> Applicat.Date: OB/18/97 <br /> 3ob Address: 21b9 MELVIN AVE <br /> Applicant N �ner: BROICAW FRED L <br /> Ten ant: Phone <br /> Proposed Use: SINGLE FAMILY RESIDENCE <br /> Desc. of Work: <br /> Describe Proposed N/ork ADDITION/REMODEL � <br /> OFFICE SET JOB SET � <br /> APPROVED FOR PERMZT: DATE /_/_ BY � <br /> _ � <br /> PROJECT ADDRES5 (if known) M <br /> Attach four(4)copies of plans for proposed wo�k-Draw to scale and nole the following i1 app�icable: W <br /> •Property Lines •Outline and dim?nsions ol all ezisting and proposed siructures on the lot •Existing and proposed utilities O <br /> 'Centeiline of street •Indicate North •Show any proposed gr.�ding changes •Show measurements � <br /> DO NOT WRl i� BELOW THIS LINE <br /> PERMIT CONDITIONS: Z <br /> 1. All calts for inspection shall be made 24 hours in advance-phone 259-8810. O <br /> 2. Ail work shail be pertormed in accordance with this permit ar.d current City of Everett Dasign and <br /> Construction Standards and Specifications. <br /> 3. Cail Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> '�..C�.e — f'��i�SC, c�et, I�;�rn b�`�J � i',n �� �c,� ���y i�'���� V/ <br /> S ,��C Sew-�,�' ��+ olc,� nC�� G���� �� �'� � � <br /> n��r�, l;.PC <br /> �;� ��� r��:,+ K���; ,-��. <br /> �� <br /> ACKNOW�EDGEMENT OF CONDI110NS <br /> The w�dersigned ownedapplicant hereby agrees to hold and sava harmless <br /> the City of Everett from any and all claims for damages,costs,ezpenses,or <br /> Approve.d lor Conslruction Date causes of action ihat may arise because o1 installation and maintenance of <br /> tho imorovement or other rght-o4way use hereto applied for and IUAher agrees <br /> to remove same upon notice from the City and to roplace publi� property <br /> damaged ihereby. <br /> FINAL INSPECTION Date <br /> ApproveA as Constructed <br /> Signature of Applicant Date <br /> WORK AUTHORIZED 8Y THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PEflM1T IS ISSUED MID THEFEAFTER IS TO BE�ILIGENTLY PURSUED TO <br /> COMPLETiON.THIS PERMIT MAY BE CANCELLED BY THE CITY VPON ANY STOPPAGE OF WORK ON THIS PROJECT OV[R 90 DAvS DUFlATION. <br />