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Y ' J <br />�"� <br />-^. �lication For <br />PUBLIC VvORKS PERMIT <br />TYPE QR PRINT ONLY <br />Ovrner <br />Applkant <br />Describe Proposed Work _ <br />PROJECT ADDRESS (if known) <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 259-881 D <br />Me Plan Check No: C 50809 <br />Applicat.Date: 02/06/96 <br />3ob Addreas: 30b9 515T PL SW <br />Owner: JAMES JERRY <br />.—.. Tenant: <br />Date <br />Public 6Vorks Permit p <br />Building Purmlt p_ <br />Public Works Fee $ _ <br />SEPA <br />Propoeed Uee: SINGLE FAMILY RESIDENCE <br />Desc. of Work: <br />GARAGE/KITCHEN/FAMILY RM ADDITION <br />OFFICE SET JOB SET <br />APPROVED FOR PEhMIT: DATE_/_/_ BY <br />Altach four (4) coples of plans tor proposed work - Draw to scale and note the following if applicable: <br />Phone <br />Ahone <br />•Property Lines 'Outline and dimensions of all existing and proposed structures on the lot •6cisting and proposed utilities <br />'Centerline of street •Indicate North 5how any proposed grading changes •Show measurements <br />PERMIT CONDITIONS: <br />1. All calls for inspection shail be made 24 hours in advance - phone 259-8810. <br />2. All work shall be performed in accordance with this permit 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 1-E�00-424-5555. <br />�UBLIC YvORKS P@RM�� <br />NO r 9�pUIREn <br />3Y� <br />---�_ <br />��TE.. 77P� <br />��- <br />Approvad for Construclion Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />� <br />O <br />♦�A <br />V♦ <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned ownedapplicant hereby agrces to hold and save harmless <br />the City of Everett from any and all dairns for damages, costs, expenses, or <br />causes ot action that may arise because uf Installation and maintenance of <br />the Improvement or other right-of-way use hereto applied tor and further agrees <br />to remove :ame upon notice from the City and to replace public property <br />damaged th:•.�cby. <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STAFiTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURSUED TO <br />COMPLEfION. THIS PEPMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 �AYS DURATION. <br />