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Acahon For <br />PUBLIC ' ORKS PERMIT <br />TYPE OR PRINT ONLY <br />Owner <br />Applicant <br />Describe Proposed Work _ <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 259-8810 <br />Date <br />Public Works Permit N <br />Building Permit N <br />Pnhlir Works Fee E _ <br />Plan Check No: B 53919 SEPA <br />Applicat.Date: 01/13/97 <br />Job Address: 1725 MCDOUGALL AVE <br />Owner: SEELBACH R BROCK <br />Tenant: <br />Proposed Use: SFR/CARPORT <br />Desc. of Work: <br />REBUILD CARPORT <br />OFFICE SET JOB SET <br />APPROVED FOR PERMIT: DATE_/_/_ BY <br />PROJECT ADDRESS (if known) <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following if applicable: <br />'Property Lines 'outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities <br />•Centerline of street •Indicate North 'Show any proposed grading changes •Show measurements <br />NOT WRITE B <br />PERMIT CCNDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. <br />2. All work shall be performed in accord-mce with this permit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1- 0-424-5555. <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />(/ ) <br />ca <br />0 <br />si <br />z <br />0 <br />Y <br />0 <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harmless <br />the City of Everett from any and all clams for damages, costs, expenses, or <br />causes of action that may arise because of installation and maintenance of <br />the improvement or other right- A -way use hereto applied for and further agrees <br />to remove same upon notice from the City and to replace public property <br />damaged thereby. <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST 3E STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />