Laserfiche WebLink
App� n Fw <br />PUBLIC WORKS PERMIT <br />OR PRINT ONLY <br />Proposed Work _ <br />ECT ADDRESS (if known) <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Sireel <br />Everett, WA 98201 259-8810 <br />Date <br />Pubiic Works Permit N <br />Building Pertnit M _ <br />Public Works Fee E _ <br />Plan Check No: C 58800 SSPA <br />Applicat.Date: OS 12/98 <br />Job Addreae: 19 4 MCDOUGALL AVE <br />Owner: MCSHSRRY HARK/MARY <br />Tenant: <br />Propoeed Uee: SINGLE FAlIILY RESIDSNCE <br />Deec. of Work: <br />FOUND'ATION REPAIR� <br />STAIRS (CHIP) <br />OFFICE <br />BATH REMODEL� REPAIR <br />JOB SET <br />APPROVED FOR PERMIT: DATE_/_/_ <br />lour (4) copies of plans for proposed work - Draw to scale and note the following if applicable: <br />Phone <br />Phone <br />•Property Lines 'Outline and dimensions of all exlsting and proposed structures on the tot •Existing and proposed uti!ilfes <br />•Center�ine ol street •Indicate North •Show any proposed grading changes •Show 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 performed in accordance with this permit and current City of Everett C?esign and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />ru�ue woRks ���n+r.� <br />r;pr R�pulRw� <br />. � Y.�....� .--- <br />�AT E _� _.�'�� <br />Approved lor Construction Date <br />FINAL INSPECTION <br />Approved as Constructed <br />� <br />O <br />�♦� <br />V♦ <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant herehy agrees to hold and save harmless <br />ihe City ol Everett irom any and all claims for damages, costs, expenses, or <br />causes ol action lhat may artse hrcause oi installatlon and maintenance of <br />the impiovemenl or other righl-of•way use hereto applied for and further agrees <br />to remove same upon notice from the Cily and lo replace pu6lic prope ,ry <br />damaged thereby. <br />Signature of Applicant Date <br />VJORK AUTHORIZED �Y THIS PERMIT MUST BE STAFiTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURSUED TO <br />COMPLEf10N. THIS PERMIT MAY BE CANCELLED BY THE CI1Y UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />