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� "°(ication Por �–. <br /> PUBLIC Vl JRKS PERMIT Date_ 3/15/96 <br /> PUBLIC WORKS DEPARTMENT Public Works Permit R <br /> 3200 Cedar Street <br /> Everett,WA 98201 259-8810 / <br /> Building Permit N --�6���C/^T <br /> IYPE OR PRINT ONLY Public Works Fee$ <br /> PAUL WARNS 11105 1ST DR SE EVERETT 98208 347-1306 <br /> Owner Mailing Address City Zip Phone <br /> OWNER <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work 11105 1ST DR SE � <br /> RESIDENTIAL ADDITION � <br /> � <br /> v/ <br /> PROJECT ADDRESS(if known) 11105 1ST DR SE � <br /> Attach tour(4)coples of plans for pmposed work-Draw to scale and note the following if applicable: O <br /> •Pruperty Lines 'Outline and tlimensions ot all existing and proposed structures on the lot •Existing and proposed utilities <br /> •Centerline of street 'Intlicate Norih •Show any proposed greding changes •Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: Z <br /> 1.All calls for inspection shall be made 24 hours in advance-phone 259-8810. O <br /> 2.AII��vork shall be pertormed in accordance with this 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 NUMBEP.1-800-424-5555. � <br /> � V♦ <br /> O <br /> +'�IBLIC 1uORKS PEFn,u• � <br /> �'�d� .9EUUIREp <br /> =Y�� <br /> sp7c -7�:� n� <br /> �- —_-... <br /> ACKNOWLEDGEMENT OF CON�ITIONS <br /> The undersigned owner/applicant herehy agrees to hold and save hartnless <br /> the City of Everett from any and all claims tor damages,costs,expenses,or - <br /> Approved for Construction Date causes ol adion that may arise because of installation and maintenance o( <br /> ihe impiovement or other right-o6way use hereto applied for and funher agrees <br /> to remo��e same upon notice from the City and to replace public property <br /> damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed <br /> Signature of Applicant Date <br /> WORK AUTHORI2ED BY THIS PERMIT MUST BE STARTED IVITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLEfION.THIS PERMIT MAY BE CANCELIED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS OURATION. <br />