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`/ -gPplicetbn Fp _. <br /> PUBLIC C JRKS PERMIT °a, <br /> PUBLIC WORKS DEPARTMENT pubiie Nbrks Permit• <br /> 3200 Cedar,4treet <br /> Everatl.WA88207 259-8810 <br /> Buili� ig permk M <br /> TYPEORPRINTONLY Plpan Check No: C 5111/1 SEPA �rksFeeS <br /> APJobcAddreee: 25125f.OMHARD AVE <br /> Owner: BARTLETT JAMES <br /> �a Tenant: <br /> Propoeed Uee: SINCLE FAMILY RESIDENCE Phone <br /> Deec. of Work: <br /> ADDITION OF LAUNDRY ROOM <br /> ApplM.ent Phone <br /> OFFICE SET JOB SET <br /> DBSCflb9 PfOpOSBd WOfk. APPROVED FOA PERMIT: DATE_/_/_ By � <br /> _ � <br /> � <br /> PROJECT ADDRESS(if known) _ � <br /> Attaeh lour(4)copies of plans for proposud work-Draw to vcale and note the folbwing il applicable: � <br /> �P�operly Llnee `Outline and dlmenslons of all axist�ng ena proposed structures on ihe bt 'Exlsting and proposed utilitles O" <br /> `CentMlne of street Mndicete North 51ar�eny pro��osed prading chanpes �Show measurements <br /> DO NUT WRI iE BELOW THIS LINE � <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspection shali be made 24 hour� in advance-phone 259-8810. <br /> 2.All work shall be pertormed in accordance with this permit and curcent City of Everett Design and O <br /> Construction Standards and Speciflcations. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-6555, � <br /> �'UBLIC WORKS PERM�` ♦A <br /> h0 r//,E'Q/�j�IR R �i/♦ <br /> r3Y_�J�!�l'�P..c� O <br /> •ATE._�_��/�f 9'(O � <br /> NDC�: cS��G'G�CuXi✓ mvd� � v���/Z���D K-teP� UPG <br /> �� New ac�%"E;a�� is bv;(� vuG/ ex�sE;n��s,-�sa..r� <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby egrees to hold and save hartniess <br /> the City of Everett from any and all claims for demages,costs,expenses,or <br /> Approved lor Construction Date causes ol action that may arise because of Installation and maintenence of <br /> the Improvement or other right-of-way use hereto applied for and lurther agrees <br /> to remove same upon notice from the Ciry end to replace public property <br /> damaged there6y. <br /> FINAL INSPECl10N Date <br /> Approved ea Constructed <br /> Signature of Applicant Date <br /> WORK AUTHORRED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURSUED TO <br /> CAMPLETION.YHIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGF OF WORK ON 7HIS PROJECT OVER 90 DAYS DURATION. <br />