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Date <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Owner <br />Applicant <br />Describe Proposed Work _ <br />Project Address (it known) <br />Plan Check No: B 44017 SEPA <br />Applicat.Date: 04/05/94 <br />3ob Ad�ner: O'BRIENZROBA� <br />Tenant: <br />Propoeed Uee: SINGLE FAMILY RESIDENCE <br />Deec. of Work: <br />REPLACE DEAPIDATED HASEMENT WITH NEW <br />FOOTINGS� F011NDATION WALLS AND EXTERIOR <br />OFFICE SET JOB SET <br />APPROVED FOR PERMIT: DATB_/_I_ BY— <br />Altach four (4� copies of Plans for proposed work • Drew to scale and nole the following as applica6le: <br />• Property Lines <br />• Outline and dimensions of all existing and <br />proposed structures on the lot <br />• Existing and proposed utili�ies <br />PUEIic woda Pe�mit • <br />ama. oeo�. � — <br />Pu�l¢ Worb Fae 5 <br />Tolel Fee <br />les� Po��. Fae P�iE S <br />BHmce Oue g <br />• Cenleriine of slreet <br />• Indicate North <br />• Show any proposed grading changes <br />• Show measurements <br />Phone <br />PERMIT CONDITIONS <br />7. P.II calls for inspection shall 6e made 24 hrs. in advance • phone 259-8810. <br />2. All work shall be performed in accordance with this Fe�mit and currenl City oi Everett Design and Construction <br />Standards and Specitications. <br />3. Cail Locallon Underground Service 48 hrs. before you dig. TOIL FREE NUMBER 1•800•424•5555. <br />PUBLIC �'�'ORKS PERMIT <br />NOT REQUIRED <br />BV � <br />DATE �' <br />Approved lor Construction Date <br />FINAL INSPECTION Dale <br />Appmved as Constructed <br />�ArI�� PUBLIC WORKS DEPARTMENT <br />3200 Cedar Slreet <br />Everett, WA 98201 <br />Phone: 259�BB50 <br />ACKNGWLEDGEMENT OF CONDITIONS <br />� <br />O <br />� <br />� <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the Cily ol Everett Irom any and all claims for damages, costs, <br />expenses, or causes of action Ihat may arise because of installation <br />and maintenance ol the improvemenl or other right•of�way use hereto <br />applied for nnd further ayrees to remove same upon notice irom the <br />Cily and to replace public property damaged th=reby. <br />Signature ol Applicant Date <br />WORK AUTHOR�ZED BY THIS PERMIT MUST 8E STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PI:RMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE 0� N'ORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />