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; � <br /> Applica6on For D6,,, <br /> PUBLIC WORKS PERMIT <br /> Public Works Permit# <br /> PUBLIC WORKS DEPARTMENT <br /> 3200 Cedar Street <br /> Everelt, WA 98201 (425) 257-8810 Building Permit# <br /> TYPE OR PRINT ONLY Public Works Fee S <br /> Owner Plan Check No.: 89909-009 'hone <br /> Job Address: 703 40TH PL <br /> Appliranl Owner: ROTERT RICHARD&KELLI �hone <br /> Tenant: <br /> Application Date: 9/8/99 ■ . ■ <br /> Describe Proposed Work Proposed Use: SFR W <br /> Type of work: FAMILY ROOM ADDITION � '� <br /> O�ce Se�_ Job Ser Fire/Planning Set � <br /> Approved For Permit: Date: _ By: '^ <br /> \d'�e� <br /> PROJECTADDRESS (if known) � <br /> Attach feur(4)copies plans for proposed work-Draw to scale and note the following if applicable: o <br /> •Pmperty Lines •Outline and dimensions of all axisting and proposed struclures on Iho lol •Existing and proposed utililies � <br /> •Centerline of street •Indicate North •Show any proposed grading changes •Show measurements <br /> DO NOT WRITE BELOW THIS LINE Z <br /> PERMIT CONDITIONS: � <br /> 1. All calls for inspection shall be made 24 hours in advance - phone (425) 257-8810 <br /> 2. All work shall be performed in accordance with this permit and current City of Everett Desigri and � <br /> Construction Standa�ds and Specifications. , <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. ♦/'� <br /> \/j <br /> �UaLIC tNORKS P�RMl'� � <br /> 31'—��aOT Ep�qRE� <br /> ' � <br /> •ATF___ <br /> �.� � _ i_ <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harmless <br /> ihe Ciry of Everett from any ant all claims tor damages,costs,expenses,or <br /> ppmve or onswcuon y�� causes of action that may arise becausr of installatlon and maintenance ot the <br /> improvement or other right-of-way use hereto applied lor and further agrees to <br /> remove same upon notice Imm the City and to replace public property dam- <br /> aged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed <br /> ignamre o pp icant ate <br /> WORKAUTFiOR�D BY THIS PERMfT MUST BE STAHTED YVITHIN 180 DAYS OF D47E pERMIT IS ISSUED AND THEREAF7ER IS TO BE DIIJGEMLY PURSUED TO <br /> COMPLEIION.iHIS PERMff MAY BE CANCELLED BY7HE CITY UPON ANY STOPPAGE OF WORK OM iHIS PfiQJECTOVER 90 DAYS DURAl10N. <br />