Laserfiche WebLink
Date PUCL�Works Pe�mil r _ <br /> Application For eiaa oeo� • <br /> PUBLIC WORKS PERMIT P°°��°W°��•F�e <br /> Totai Fre S _ <br /> Less Aoo�.Fee Paia $_ <br /> Print or Type Only ea�a�«o�e s_ <br /> Plan Check No: C 43183 SEPA <br /> Owner Applicat.Date: O1/10/94 Phone <br /> Job Addresa: 1020 E MARINE VW DR ' <br /> Owner: CHRISMAN KEVIN <br /> Tenant: <br /> Propoaed Uee: SINGLE FAMILY RESIDENCE Phone <br /> Applicant Deec, of Work: <br /> CONSTRUCT 2 STORY ADDN <br /> Describe Proposed Work <br /> OFFICE SET JOB SET <br /> APPROVED FOR PERMIT: DATE_/_/_ gy <br /> � <br /> Prolect Address(it known) � <br /> Attach four(4) copies of plans tor proposed work• Draw to scale and note lhe following as applicable: � <br /> • Pronerty Linec • Centerline ot street � <br /> • Outline and dimensions of all existing and • Indicate North <br /> proposed structures on the lol • Show any,,roposed grading changes <br /> � Existing and proposed utilities � Show measurements � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All calis for inspection shall be made 24 hrs.in advance-phone 259•8810. � <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design and Construct(on <br /> Standards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.before you dig TJLL FREE NUMBER 1•800•424•5555. � <br /> O <br /> PUSLIC W6RK6 PERMIT � <br /> NOT REQUIRED � <br /> BY ODATE_ ` <br /> a <br /> ACKNOWLEOGEMENT OF CONOITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm• <br /> less the City ot Everetl from any and all claims lor damz�es. costs, <br /> expenses, or causes of action that may arise because of installation <br /> and maintenance ol the improvement or other righhoFw3y use herrto <br /> applied lor and turther agrees to remove same upon notice irom ihe <br /> Approved for Construction Date City and to replace public property damaged thereby. <br /> FINAL INSPECTION Date <br /> Approvetl as Constructed Signature ol Applicant Date <br /> � ���� PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CedarStreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA�9201 BE OILIGENTLY PURSUED TO COMPLETION. THIS PER�11T MAY BE <br /> Phone:259-A870 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON TH�S <br /> PROJECT OVER 90 DAYS DURATION. <br />