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Date <br />-ti <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or'fype Only <br />Owner <br />Applicant <br />Deacribe Propos�d Work <br />Projecl Address (if known) <br />Plan Check No: <br />Applicat.Date: <br />Job Addreee: <br />Owner: <br />Tenant: <br />Propoeed Use: <br />Desc. of Work: <br />KITCHEN DINING <br />B 41894 SEPA <br />09/O1/93 <br />2705 TAYLOR DR <br />LAMEY DAVID & EMILY <br />SINCLE FAMILY RESIDENCE <br />ADDN <br />OFFICE SET JOB SET <br />APPROVED FOR P&RMIT: DATE_/_�_ gy <br />Attech tour (4) copies of plens for proposed work • Draw to scale and note t�e following as apptfcable: <br />� Property Lines <br />• Outline end dimensions of all existing and <br />proposed atruCtures on ihe lot <br />• Exfsting and pro0osed utllities <br />PuCiic Work� Parmlt • <br />BiEq.Oao� � _ <br />PueiK Work� Fea <br />Tobl Fe� S <br />Les� Appl FN P�q S <br />e�l�n�s Ou� S <br />• Centerline ol street <br />• Indicate North <br />• Show any proposed grading changes <br />• Show measurements <br />Phone <br />Phone <br />PERMIT CONUITIONS <br />1. All calis for Inspection shell be :nade 24 hre. in advance • phone 259�8810. <br />2. All work ehall be peAortned in accordance with thia permit end curtent City of Everett Design and Construction <br />Stendarda a•id Specilicetlons <br />3. Call Locetlen Underpround Service 48 hrs. before you dip. TOLL FREE NUMBER 1-800�424-5555. <br />�UBLIC WORKS PERMIT <br />NOT qE0U1qED <br />BY <br />OATE 3 <br />Approved for Constructic �. Date <br />FINAL INSPECTION Date <br />Approved as ConstruCteA <br />�FUBLIC WORKS DEPARTMEI�T <br />3200 Cedar Street <br />Everep, WA 98201 <br />Phone: 259•8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />r <br />� <br />The undersig-ed owneryappiicant hereby agrees to hold and save ha�m- <br />less the City of Everett from any and all cleims tor tlamages, costs, <br />eKpenses, or causes of action that may arise because ol installetion <br />and maintenance of the impr�vement or other right•of•way use hereto <br />applied for and further agrees to remove same upon notice from the <br />City and to replace public property damaped thereby. <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITH�N <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY 8E <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />