Laserfiche WebLink
Date <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Owner <br />Applitant <br />Describe Proposed Wor'� <br />Projact Address (if known) <br />Plan Check No: C 46673 SEPA <br />Applicat.Date: O1/06/95 <br />Job Addreee: 1910 W MUKILTEO BLVD <br />Owner: COOKE CLARK <br />Tenant: <br />Propoaed Uee: SINGLE FAMILY RESIDENCE <br />Desc. of Work: <br />REMODEL, NEW FOUNDATION <br />OFFICE SET JOB SET <br />APPAOVED FOR PERMIT: DATE_/_/_ BY, <br />PUCIie Works Pe�mlt • <br />BIEp. Deo�. � - <br />PuOhc Warws Faa <br />TolelFee S <br />Less Appl Fee PeiO S <br />Balance Oue S <br />Phone <br />Zip Phone <br />Attach four (4) copies of plans for proposed work • Draw to scale and note the loltowing as appticable: <br />• Property Lines • Centerline of street <br />� Outline and dimensions of atl axisting and • Indicate North <br />proposed structures on the lot • Show any proposed grading changes <br />• Exisling and proposed utilities • Show measurements <br />� � PERMITCONDITIONS <br />; , . 7. All calls for inspection shall be mede 24 hrs. in advance - phone 259•8810. <br />. 2. All work shell be peAormed in accordance wlth this permit and current City of Everett Design and Constructfon <br />Standards and Specifications <br />. 3. Cell Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800-424•5555. <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />����PUBLIC WORKS DEPARTMENT <br />3200 Cedar Streel <br />Everett, WA 98201 <br />Phone:259�8810 <br />r`UBLIC WORKS PEPMIT <br />N REOUIRE!? <br />DY � <br />uATE`�- 9—is" <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />H <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm• <br />less the City ot Everett Irom any and all claims Icr demages, costs, <br />ezpenses, or causes af action that may arise 6ecause 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 irom the <br />City and to replace public property damaged thereby. <br />Signature ol 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 DIL�GENTLY 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 />