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Date �� ' � <br /> Pubi�c\Yorxs PnrmJ• <br /> oiaco�w.. �"�!�>> �:in <br /> Applicalioi�For � <br /> PUBLIC WORKS PERMIT Pu�LCWoasFee <br /> TottlFee S <br /> Less�opl Fee PaiU $ <br /> Baiancc0ue S <br /> Print or Type Only <br /> � <br /> A�]C <br /> Q �"� Plan Check No: B 27910 SEPA <br /> 9 H fA Owner p,�plicat.Date: 10/09/91 Zip Phone <br /> � Job Addre: 2207 ROCxEFELLER <br /> y �N Owner: MARKS, DOAOTHY J <br /> fC C] Tenant: <br /> ��Q Applicant Prcpoaed Uee: SINGLE FAMILY RESIDENCE Zip Phone <br /> ,�y H Deec. of Work: <br /> OUILD FOUNDATION UNDER EXISTING HOUSE <br /> H <br /> � Describe Praposed Work <br /> � O� OFFICE SET JOB SET <br /> H <br /> � H APPA'!D FOR PERMIT: DATE_/_/_ By <br /> �f�� g <br /> ^,V � <br /> zy� Project Atldress(il known) L <br /> �y~ y Attach lour(4)copies ol plans for proposed work• Draw to scale and note the lollowing as applicable: s <br /> N <br /> ��� • Property Lines • Centerline ol street ,f <br /> • Outline and dimensions ol all pxisting and • Indicate North V t <br /> t'� proposed structures on the lot • Show any proposed grading changes <br /> t�� • Existing and proposed utilities • Show measuremeNs <br /> H � y � <br /> DO NOT WRITE BELOW THIS LINE � <br /> �� PERMIT CONDITIONS <br /> , 1.All calls for inspection shall be made 24 hrs.in advance� ione 259•88�0. � <br /> 2.All work shall bo performed in accordance with Ihis perm, nd current City ol Everett Design antl Construction � <br /> � Standards and Specificalions. <br /> � �_' 3.CaIILocationUnderqroundService4Bhrs.beloreyoudig.TOLLFREENUMBERI•800-424•5555. � <br /> � <br /> � � <br /> � ���� �� ��iV�✓l� p�L'i�, I���f'j� � <br /> V <br /> � ��� r���lti�� (� � <br /> 1 � <br /> ,-- <br /> a <br /> __� <br /> ACKNOWLEDGEMENT Of CONDITIONS <br /> 1� The untlersigned owner/applicant hereby agrees to hold and save harm� <br /> .� less Ihe City ol Everett Irom any and all claims for damages, costs <br /> expenses, or causes of adion that may arise because ol installatinr <br /> - � and maintenance ot the improvement or other right-ol�way use heretc <br /> applied lor and �urther agrees to remove same upon nolice Irom ih� <br /> Approved lor Conslruction Date Ciry and to replace public property tlamaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Construcled Signature ol Applicant Date <br /> ��rl�� WORK AUTHORIZED BV THIS PERMIT MUST BE STARTED WITHI� <br /> PUBLICWORKSDEPARTMENT 1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TC <br /> 3200CedarStreet BE DILIGEN7LY PURSIIED TO COMPLETION.THIS PERMIT MAY BE <br /> Everelt,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259•8810 PROJECT OVER 90 DAYS DURATION. <br />