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� � �tbn For ( <br /> PUBLIC 1NORKS PERMIT Date <br /> PUBLIC WORKS DEPApTMENT public Works Pertnit N <br /> 3200 Cedar Street <br /> Everett,WA 98201 259-8870 Building Permit N <br /> TYPE OR PRINT ONL`� Public Works fee S <br /> Plan Ch�ck Nos C 57925 SEPr � <br /> Owner 71pp licat.Dat�: 02 17/98 Phone <br /> Job 11ddr���s 56 7 itBST DR <br /> O�mers MAY KIRR 4 LINDA <br /> Ton�nt: <br /> Propo�ed U�as SINGLB FAMILY RSSIDENCS <br /> Applicant Deec. of Norks Phone <br /> 1►DDITION – F7IMILY ROO!!/BBDROON/HATH � <br /> Describe Proposed Work _ � <br /> OFFICE SET JOB SBT <br /> 1►PPROVED FOR PERMIT: DA2B_/_/_ BY � <br /> � <br /> — � <br /> PROJECT ADDRESS(if known) � <br /> Attach foiir(4i coples ol plans for proposed work-Oraw lo scale and note the following if appll:able: O <br /> •Property Lines •Outline and dimensions o1 all ezisting and pmposetl slractures on the(ot •Existing and proposed utilkies <br /> •Centerline ol street •Indicate Nonh •Show any propose.d grading changes •Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: � <br /> 1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. O <br /> 2.All work 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 NUMBER 1-800-424-5555. � <br /> V♦ <br /> �OQLIG WpP,KS �ERMf� O <br /> NOi,/�A,,fc-UUIR�A � <br /> I Y__��il`V`.– <br /> 1 " <br /> �nrt:.---�%.T� ti?� <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby aqrees to hold and save harm�ess <br /> the City of Everett from any and all claims for damages,costs,expenses,or <br /> Approvetl lor Construction Date causes ol action ihat may arise because ot installation and malntenance of <br /> the impmvement or other right-ol-way use hereto applied for and further agrees <br /> to remove same upon notice from the City and to :eplace public property <br /> tlamaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constmcted <br /> Signature of Applicant Date <br /> INOqK AUTHORIZED DY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THERFAFTER IS TO BE DILIGENTLY PURSUED TO <br /> CCMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br /> l <br />