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� �WKatwn For <br /> PUBLIC WORKS PERMIT °a� <br /> PUBIIC WORKS DEPARTMENT Public Works Permit M <br /> 3200 Cetlar Street <br /> Everett,WA 98201 259-8870 Building Pertnit N <br /> TYPEORPRINTONLY Plen Chock No: C 53679 SEPA yyo�sFeeS <br /> Appllcat.Dat�: 12/05 96 <br /> Job Addr�s 1527 TlIORE AVE <br /> Owners CONLSY ERIN <br /> Owner T�nsnt s <br /> Pcopo�ad U�es SINGLS FANILY R%SIDENC6 Phone <br /> Deec. of ilork: <br /> RfitlODBL 11ND ADDITION <br /> Appiicant � <br /> OFFICB S6T JOB S6T Phone <br /> Describe Proposed Worl APPRVD FOR PEAMIT: DATE_/_/_ BY � <br /> � <br /> � <br /> �/ <br /> PROJECT ADDRESS(if known) � <br /> Attach four(4)copies of plans for proposed work•Diaw to scale and note ihe following if applicable: <br /> •Property Lines •Outline and dimensions of all existing and proposed structures on the Iot •Existing and proposed utilities O <br /> •Centerline of street •Indicate NoAh 'Show any proposed grading changes •Show measuremenis � <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. <br /> 2. AII work shail be performed in accordance with this permit and current City of Everett Design and O <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> �x��{�. Jl�CG�� I�Vn vndfiY -�, �(D�v� � . <br /> O <br /> �i���1�� ).�e ��v,�br� �,�,� �M u�y-�� a, <br /> s�d��,� -� ,���� u_P�. <br /> N� /�u� pv,�m d�apc��r,�. <br /> �- <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned ownedapplicant hereby agrees to hold and save hartnless <br /> Ihe City of Everett trom any and all claims tor damages,costs,expenses,or <br /> Approved lor Construcuon pa�e wuses ol action Ihat may arise because ot installation and maintenance of <br /> the improvement or other right-ol-way use hereto applied for and further agrees <br /> to remove same upon nolice from the City and to replace public property <br /> damaged thereby. <br /> FINAL INSPECTION Date <br /> Approvetl as Constructed <br /> Signature of hpplicanl Data <br /> 11'ORK AUTI10R12ED 8Y TNIS P[FMIT pAUST BE STAR7ED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED FNO THEREAF7ER IS TO BE DILIGENTLY PUflSUED TO <br /> COMPLETION.THIS PERMIT A1AY BE CANCELLED BY THE CIN UPCN ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 OAYS DURATION. <br />