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CApplication For Da1e <br /> PUBLIC WORKS PERMIT <br /> Public�Vc•4s Permit N <br /> PUBLIC WORKS DEPARTMENT <br /> 3200 Cedar Street <br /> Everett, WA 98201 (425) 257•8810 Building Permit H <br /> TYPE OR PRINT ONLY Public Works Fee$ <br /> Plan Check No: C 62592 SEPA <br /> Appllcat.Date: OS/27/99 <br /> Job Addreee: llil KOCKEFLLER AVF. <br /> Owner Owner: SEAGRAVE GARY Phone <br /> Tenant: <br /> Propoeed Uee: SINGLE FAHII�Y RESIDENCE <br /> Applica��t Deec. of Works <br /> TWO STOkY ADDITION Phone <br /> Describe Proposed Work _ oeeicE SET _JOB SET W <br /> APPROVf:D FOR PERMIT: DAT6_/_/_ BY � <br /> � <br /> �/ <br /> PROJcCTADDRESS (if known) m <br /> Attach four(4)copies pians for proposed work•Draw to srale and note the following if applicable: O <br /> •Property Lires •Outline and dimensions of all ezisling and proposed structures on the lot •Existing and proposed utilities � <br /> •Centedine ol street •Indicate North •Sho�+any proposed grading changes •Show measurements I <br /> DO NOT WRITE BELOW THIS LINE Z <br /> PERMIT CONDITIONS: O <br /> 7. All calls for inspeciion shall be made 24 hours in advance - phone (425) 257-8810 <br /> 2. All work shall be performed in accordance with ihis 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 1-800-424-5555. //� <br /> ♦/♦ <br /> O � <br /> a <br /> 'UDLIC NJ�^,f�S 5"R;.+� � <br /> IiGT ,�cUl•VR��+ � <br /> K/l�n <br /> 4Y,__.�" �v•/ . <br /> •e.TF;.__�.�./_�� _ —_ <br /> � � <br /> � <br /> ! <br /> I <br /> � <br /> ACKNOWLEDGEMENTOFCONDITIONS . � <br /> The undersigned owner/applicant hereby agrees to hold and save hartnless I <br /> the Ciry ot Everett Irom any and all claims for damages,costs,ezpenses,or <br /> prove or ons ruction ate causes of actlon ihat may arise because of installation and meintenance of the <br /> improvement or other rightof•way use hereto applied lor and lurther agrees to <br /> remove same upon notice Irom the City and to replace public propeAy dam• <br /> aged there6y. <br /> FINAL INSPECTION Date <br /> Approved as ConstruMed <br /> igna ure o pp ican a e <br /> WORK AUTHOR�D BY THIS PEHMR MUST BE STAFiTED WI7}iIN 180 DAYS OF DAIE PERMR IS ISSUED AND iHEREAFfER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLE'fKNJ.THIS PERMR MAY BE CANCELLED BY THE CfTY UPON NJY STOPPAGE OF WORK OV THIS PRQECT OVER 90 DAYS WRATION. I <br />