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� PUBL►C S..JRKS PERMIT °'�' _ <br /> PVBt1C WORKS DEPARTMENT ���� <br /> 3200 Cedar Street <br /> Fverett,WA 9l201 259-8810 ��p«�• <br /> iYPE OR PRINT ONLY P"����s <br /> �� Pian Chack Nos C 52420 SEPA p�,� <br /> Appllcat.Date: 07/29/96 <br /> Job Addres 571b ti�ST DR <br /> Ownars S11�LL8R I(URT <br /> TMaift i �� <br /> Applicant � pcopo��d Uses SINGLE FAMSLY RHSIDENCE <br /> Deec. of Work: <br /> TWO STORY ADDITION � <br /> Describe Proposed Work_ <br /> OFFICB SfiT J06 SfiT <br /> APPRVD FOR PEAMIT: DATE_/_/_ BY � <br /> � <br /> PROJECT ADDFESS(if known) _ - /� <br /> Atlaeh four(4)copies ol plans for pioposed work•Drew to scale and note tha folbwing i1 epplkable: ��+ <br /> �property L1nes 'Outline and dimensions ol all existing and proposed structuroa on t�e bt �Istirq and popoxd utiNties O <br /> �CentMina o1 stteet •Indieate North �S�ow eny propoeed gradinq changes 5how tr�surert�ents � <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspectlon shall be made 24 hours In advance-phone 259-8810. o <br /> 2.All work shall ba pertormed in accordance with this pertnit and current City of Everett Design and <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Servico 4B hrs. before you dig. TOLL FREE NUMBER 1-800-424-SS55. � <br /> � <br /> O <br /> a <br /> �uauc tYo�Ks renu,�ifi <br /> r�Or REOUIR6� <br /> �Y_�i5 r' �K+ �" �,, 1 <br /> fIATE� -_ 9�_ b--•• �!Ll.Lv (Dp,t�� G/f'1/fA��"' <br /> y,w...� 7•,.�' u..�°�"„ <br /> p.?,�.�..-�-� �(1v. <br /> N�..� fLQi""`j`�. �A'''""'�' <br /> — ACKNOWLEDGEMENT OF CONDITIONS <br /> 7Te undersigned ownerhppAcant AereDY apRes 10 hold end�ae hrmba <br /> the City ot Everett fiom eny and�N Gaims la drnapee,costs,axp�row.a <br /> tauses ol actbn tMl mry�risa bse�usa of ine4Aatbn and mak+te�ancs ot <br /> ApprovedtnrConstruction Date t������p���y�rytol•wayuseheretoeppliedforandhxthersGress � <br /> to mrave same upon notice hom the City e�d to reptece pubGe pro{�rb <br /> damaged ihersby. <br /> FINAL INSPECTION Date <br /> Approved as Conswcted <br /> Signature ol Applicant Date <br /> WORK AUTHORIZE7 6Y TriIS P[RMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND iHEREAFTER IS TO BE DILIGEYTLV PURSUED TO <br /> COMPLEIION.THIS PERh11T MAY BE CANCElLEO BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER BO JAYS DURATION. <br />