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� <br />� <br />TYPE OR PRINT ONLY <br />�liutbn Fa <br />PUBLIC VC JRKS PERMIT <br />Owner t <br />Applicant 1 <br />Describe Proposed Work <br />PROJECT ADDRESS (if known) <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedei Street <br />Everett, WA 98201 259-8810 <br />Plen Check No: B 50095 <br />Appllcat.Date: 11/20/95 <br />.7ob Addre: 5315 5 2ND AVE <br />Owner: HODc:ES WARREN <br />Tenant: <br />Deec�ofdNotk SINGLE FAMILY <br />ADDITION OF SHOP/GARAGE <br />Datel � <br />PuWk Waks PertnM M <br />e��amB �ic M _ <br />Public Nbrks Fee S _ <br />SEPA <br />RESIDENCE <br />OFFICE SET JOB SET � <br />APPRVD FOR PERHIT: DATE_�_�_ gy <br />Attach four (4) copias af plans for proposed work - Draw to swle and rwte the follawing if applkeble: <br />Phone <br />Phone <br />RmpeAy Lines �Outline and tlimensions of all ezisting and proposed structures on the bt �Existing and proposed utiAtlea <br />'Centerline of street �Intlicate North 5how any proposed grading changes �Show measurements <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. <br />2. All work shall be perfortned in accordance with this pertnit 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 NUlNBER 7-800-4246666. <br />�UOLIC WORKt pGAWi� <br />r;Oi qEdy��q <br />►y <br />nATE., �.S ` <br />Approved for Conslruction Date <br />FINAL INSPECTION <br />Approved as Constructed <br />.S'l�c,I�c��c� �tn�r�J/-a�o5aa� <br />lt�+: �o.� 7+rur7� /-.oea-t U_P.C'. <br />!v. �f� rL� a .,�s �a �oPc ��e.-.Q C, <br />ACKNOWLECGEMENT OF CONDITIONS <br />The underslgnud owner/applicaM hereby aqrees ta hold entl save harmless <br />the C1ry of Everap from any entl ell ciaims for tlameges, costs, axpemes, a <br />causes ot adion that may arise beceuse ol instaHatbn and melntenenca ot <br />ihe improvament or other rfpM-of•wey uee hereto appNed for and lurttxr agrsey <br />to romove same upon notice trom the City end to replece publlc prop�ty <br />demaged thereby, <br />Signatura of Applicant pe� <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMR IS ISSUED AND THEREAFfER IS TO BE DILIOENTLY Wq$UED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPR4GE OF WOqK ON THIS PRQIECT OVER 90 DAYS DURATpN. <br />