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� PUBLIC S.ORKS PERMIT Dat� <br /> PUBLIC�WORKS DEPARTMENT . . _. . . p�plic Nbrks Permn� <br /> 3200 Cedar Street '_--. _ . - _ .. <br /> Everott,WA 98207 259•BB70 <br /> Buildirq Perm:l N <br /> TYPE OR PRII Plan Check No: C 51603 SEPA <br /> A pLicat.Date: OS/02/96 Publ�NbrksFoeS <br /> pJob Addreee: 4504 TERRACE DR <br /> Owner: MEDAK KATHIE <br /> Tenant: <br /> Owner Proposed Uae: SINGLE FAMILY RESIDENCE <br /> Desc. of Work: LP Phone <br /> 12 X 14 L�ININ RM ADDITION <br /> Applicant OFFICE SET JOB SET 2ip pry«b <br /> Describe Pro APPROVED FOR PERMIT: DATE_/_/_ BY <br /> W <br /> H <br /> - <br /> PROJECT ADDRESS(if known) � <br /> Attach four(G)copies o1 plans for proposed wak•Drew to scale and note the foilowing N applkable: �w <br /> •Property Linas 'Outllne and dimensions ol all existing end proposed structures on Me lot •Existing antl proposed uti�ities �� <br /> `Centerline of street 9ndicete North 5how any proposed grading changes 5how measuremmts <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: � <br /> 1. All calis for inspection shall be made 24 hours in advance-phone 259-8810. <br /> 2.All work shall be pertormed in accordance with this pertnit and current City of Everett Design and O <br /> Gonstruction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-42h5555. � <br /> V♦ <br /> �� {� ( ; � \Uor��_S ���r,;� ����- �e�u��ec� Q <br /> a <br /> (�i� l�t ��- <br /> S/�l cc� <br /> ACKNOWLEDGEMENT Of CONDfTiGNS <br /> The undersigned ownedapplicant hereby agrees to hold entl save harmless <br /> the Ci.y of Everett trom any and all claims for damaaes,costs,expensas,w <br /> Approved for Construction Date causes of actlon ihat may arise because of installation and maintenance of <br /> the impiovement or other right-ol-way use hereto epplied for and further ag�ees <br /> to remove same upon notice Irom ihe Ciry arM to repiace public property <br /> damaged thereby. <br /> FINAL INSPECTION Dato <br /> Approved as Constmcted <br /> Signature of Applicant peta <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAVS OF DATE PERMIT IS ISSUED AND THEREAF7ER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLETION.THIS PEHMIT MAl'BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. � <br />