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Date <br />Application For <br />P"UBLIC WORKS PERMIT <br />Print or Type Ordy <br />Plan Check No: C 48208 <br />Applicat.Date: 04�28/95 <br />Job Addre: 240 56TH Si SW <br />Owner: TU YUAN-PO <br />Owner Tenant: <br />Applicant <br />Describe Proposed Work _ <br />ProJect Address (if known) <br />SEPA <br />Propoeed Use: SINGLE FAMILY RESIDENCE <br />Desc. of Wozk: <br />REMODEL OF KITCHEN <br />OFFICE SET JOH SET <br />APPRVD FOR PERMIT: DATE_/_/_ BY <br />Pu01ie Works Permit i <br />eiea o.o� . — <br />WOlic Warka Fee <br />To1�IFas S <br />Lef! Appl Fes P�IE S <br />Babnn Oua S <br />P Phona <br />Attach four (4) copies of plans )or proposed work - Draw to scale and note the following as applicable: <br />• Property Lines <br />• Outline anc dimensions of all existing and <br />proposed structures on the lot <br />• Existing and pruposed utiiities <br />• Centertlne of street <br />• Indfcate North <br />• Show any proposed grading changes <br />• Show measurements <br />Phone <br />PERMITCONDITiONS <br />t. Atl calls for inspection shall be made 24 hrs, in advance - phone 259•8810. <br />2. AI! work shall be peAormed in accordance with this permit and curtant City of Everett Design and Construction <br />Standards and Specificatfonr. � <br />3. Call Locatton Underground Service 48 hrs, before you dig. TOLL FREE NUMBER 1-800�424•5555. <br />'UBLIC W09KS PER1�I�s <br />h0 f QEOU1REw <br />. y��B- <br />'AT�. . 5��..95 <br />�~ --.�._.._.. <br />Approved for Consiruction Date <br />FINAL INSPECTION Dale <br />Approved as Constructed <br />���I� PUBUC WORKS L EPARTMENT <br />7200 Cedar Streaf <br />Fverett, WA 98207 <br />Phone:259-8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />� / <br />� <br />O <br />� <br />� <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City of Evere:t from any and all claims for damages, costs, <br />expenses, or causes of actlon that may e�ise because of installation <br />and maintenanre of the improvement or other right-of•way use hereto <br />applied for and further agrees to remove same upon notice from ihe <br />City and M replace public praperty damaged thereby. <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTEU WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS �TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DUf;ATION. <br />