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� PUBLIC 1j►JRKS PERMIT �S°�-r 3/7/96 <br /> aueuc woRKs oeanrrrMerir wbi�wor��n r <br /> 3200 Ceder Sheet <br /> Everett,WA 98201 259-8810 Building Permit N <br /> TYPE OR PRINT ONLY Public Works Fee S S 1054 <br /> Patrick 0'Connor 1105 Rockefeller Ave 98201 259-4337 <br /> Owner Mailing Addrass City Zip Pha�e <br /> Applicant Malling Address City Zip phone <br /> Describe Proposed Work Addition ■ , ■ <br /> W <br /> � <br /> � <br /> � <br /> PROJECTADDRESS(if known) 1105 Rockefeller Ave � <br /> Attach four(4)copies ot plans for proposed work-Draw to scale and rote the folbwing B applicabte: O <br /> 'Property Lines 'Outline and dimensions ot all existing and proposed strueturas on the bt 'Existing and proposed utilRles <br /> `Centerline of street •Indicate North 'Show any prq»sed greding changes `Show measurements <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspection shall be made 24 hours in advance-phone 259-8810. O <br /> 2. All work shall be pertormed in accordance with this pertnR 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 1-800-424-5b55. � <br /> � <br /> � <br /> O <br /> 'I�RLIC WORKS PERM�' a <br /> �+O f q QUIREP <br /> � 4y <br /> ?Y_ _ <br /> ►ATF. �L;� <br /> � <br /> ACKNOWLEDGEMENT OF CONDITiONS <br /> The undersigned ownedeppllcanl hereby agrees to hold and save hartnbe� <br /> the City of Everatt hom any and all claims for damages,costs,expenses,a <br /> Approved lor ConstrucNon Date — ��o(actlon that may arise because of installatbn and maintx�ar�ce o} <br /> the improveifient a other righFof-way uee hereto applied ior end hxtl�epreee I <br /> to rertwve same upon rrotke hom the City and to replace pudk property I <br /> damaged thereby, i <br /> FINAL INSPECTION Oata � <br /> Approved as Constructed <br /> Signature of Applicent pate � <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STAfliED WIhIIN 180 DAYS OF WTE PERMR IS ISSUED AND THEREAFTER IS TO BE DILI6ENTLY PURSUED TO <br /> COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPACiE OF WORK ON THIS PRQIECT OVER 90 WYS W RAT10N. I <br />