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� <br />� <br />TYPE OR PRINT ONLY <br />N�,ation For <br />PUBLIC W.�RKS PERMIT <br />PUBLIC WORKS DEPAR7MENT <br />3200 Cedar Street <br />Everett, WA 98201 259•8810 <br />Ow�er Maitir <br />APP����t Mailii <br />Describe Proposed Work <br />PROJECT ADDRESS (if known) <br />Plan Check No: <br />Applicat.pate: <br />Job Address: <br />Owner: <br />Tenant: <br />Proposed Use: <br />Deac. of Work: <br />ADDITIpN <br />8 51553 <br />04/29/96 <br />5619 SOUND AVE <br />DAHL KEVIN <br />Date _ <br />Public Nbrks PertnH 8 <br />Building Permit N _ <br />Public Nbrks Fee E <br />SEPA <br />SINGLE FAMILY RESIDENCE <br />OFFICE SET-JO6 SET <br />APPROVED FOR PERyIT: DATE��_�_ <br />Phone <br />Phone _ <br />Attach four (4) copies of plans for pioposed work - Drew to scale and note the tollowing H epplkable: <br />'P�operty lines �Outline and dimensions of all existing end proposed structures on the lot •Ezlsting and proposed utilNies <br />'Centerline ot straet •Indicata North 5how any proposed greding ehenges 5how measurements <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. <br />2. All work shall be performed in accordance with this pertnit 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 7-800-4245555. <br />:�ALIC WpRNS PERMI) <br />�%Ot REOUIREY <br />•aT�S p /r� - <br />��— ---�. <br />Approved for Constructlon Date <br />FINAL INSPECTION Date <br />Approved as Construeted <br />� <br />O <br />♦�^ <br />V♦ <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigr,ed owner/applicant hereby agrees to hold and save harmless <br />tha City af Everett from any and all clalms for damages, wsis, expensns, or <br />causes o( actlon that may arise because of installation and maintenance of <br />the impfovemenl or other righhaf-way use hereto applied torand lurther agrees <br />to remove same upon notice fiom the City and to replace public p1operty <br />demaged thereby. <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE OILIGENTLY PURSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />