Laserfiche WebLink
� G U L�I� <br /> Ih.�i <br /> AiK, Pubbc Wa�ka Permil� �� <br /> Date eiea oec� • <br /> qpplication For <br /> pl1g�IC WORKS PERMIT Pu01iCWorksFee s_ <br /> Talel Fe^ <br /> Less Ao01.Fee Pa�O $--�— <br /> Balance Due s—�'� <br /> Print or Type Only <br /> Plan Check No: C 43275 SEPA Phone <br /> �__. Applicat.Date: O1/19/94 <br /> Ownz. Job Addreae: 20b1 ROCKEFELLER <br /> Owner: BROWN 6 WHITWER <br /> Tenant: <br /> Propoeed Uoe: DUPLEX Pho�e <br /> Desc. of Work: . <br /> Applican� REMODEL DUPLEX �- ��;Y <br /> Describe Proposed Work _ OFFICE SET JOB SET <br /> APPROVED FOR ?ERMIT: DATE_/_/_ HY <br /> � <br /> � <br /> Pro�ect Address(if known) � <br /> Attach four(4)copies ot plans for proposed w�rk- Draw lo scale and note�CQolteWine of stPeeii able: � <br /> • Pr�perty Lines � Indicate North <br /> • Outline and dimensions ol all existing and � ghow any proposed grading changes � <br /> proposed slructures on the lot � $how measurements <br /> • Existing and proposed utilities <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS � <br /> 1.All calls for inspeclion shall be made 24 hrs.in advance•phone 259•8810. <br /> 2.All work shall be peAormed in accordance with this permit and current Cily of Everelt Design and Construction � <br /> Slandards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•B00"424•55 • <br /> PUOLIC WORKS PEHMIT O <br /> NOT ECUIRED <br /> BY �DATE_� �O <br /> � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/apP�icant hereby ag�ees to hold and save harm- <br /> less the City of Everr.tl Irom any and all claims for damages. costs. <br /> e%Penses. or causes of action that may arise because of insla�lalion <br /> and maintenance of the improvemenl or other righl-ot-way use herelo <br /> applied lor and further agrees to remove same upon notics irom the <br /> Date City and to replace public propertY damaged thereby. <br /> Approved tor Construction <br /> Date Dale <br /> � FINAL INSPECTION Signature of Applicanl <br /> Approved as Construcled WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> � PUBLIC WORKS DEPARTMENT gE DI�LIGENTIY�PURSUED TOICOMPLE�TION.DTH SEPERMIT MAY BE <br /> 3200 Cedar Slreel <br /> Everett.WA 962�� CANCELLED BY THE CITY UPON ANY STOPPAGE OF WOFK ON THIS <br /> Phone:259�8810 PROJECT OVER 90 DAYS DURATION. <br />