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Date 6 21 95 <br />Application Fer <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />.IOHN OCHSNER <br />Uwner <br />ANDY EIOMA <br />Describe Proposed Work <br />Projer.� qddress (il known) <br />2565 31ST AVE W <br />MaiBng nCdreSs <br />952-9625 <br />Mr,i6nq Address <br />SEATTLE 98199 <br />C�ty _ <br />SECOND STORY ADDITION - SFR <br />708 32ND ST <br />Popbr. WorFs Permit s <br />em� oeoi.. 48674 <br />Putihc Works Fee <br />Ta�N FPC S <br />Less Appl. Fne Pai� u <br />�alance Cuc $ <br />286-9241 <br />Z�P Phone <br />��P Phona <br />Atlach four (4) copies of plans br proposed work � Drav.� to �calN ,�n,y ncte �he totlowing as anU�icabie: <br />• Property Lines • Centerline ol sireel <br />• Ou�line and dimensions of all existing anA • Indicate North <br />proposed slrucWres on the lot • Show any r.roposed gratlinc� chanyes <br />• Existing and proposed utilities • Show measurements <br />PERMIT CONDITIONS <br />i. All calis for inspection shall be made 24 hrs. in advance - phone 259•$$S 0. <br />2. All wo�k shall be performed in accordance with this permit and current City of Everelt Design and Constr�ction <br />Standards and Specifications. <br />3. f:all Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-$0p-424-5555. <br />�UBLfC WORKS PERMIT <br />Iv0,�7� RE�UIREn <br />tY�..--- <br />LATE � - L' �� r <br />ACKNOWLEDG[MENT OF CONDITIONS <br />W <br />� <br />� <br />� <br />� <br />O <br />__ _ The undersignetl owner/appGcant hereby ag�ee5 �o hold and save harm� <br />—� less the Cdy of Everett Irom any and all ctaims lor damages. cosis. <br />� expenses, or causes ol action that may aris= �ecause of instailation <br />� and mamtenance o! lhe imprOvemen� or u�her right-o�-way uSP. here�o <br />Approved fo� Construction I appl�r,d lor and lurther agres to remove same upon nolice from the <br />Date � Gty and to replace public property damaged Ihereby. <br />F�NAL INSPECTION Date <br />Approved as Cea�iructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar St�eet <br />Everet:. WA 98207 <br />Phone:259•8810 <br />SiqnaWre pf qpphcant Date <br />WOHK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />1A0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLI' PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLEO BY THE CITY UPON ANY STOPpAGE OF WORK ON THIS <br />PRO.IECT OVER 90 DAYS DURATION. <br />