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Date <br />Application For <br />PUBLIC WORKS PERMIT <br />Plan Check No: B 40946 SEPA <br />Applicat.Date: 06/11/93 <br />Print or Type Only Job Addrs: 629 33RD ST <br />y Owner: HAWKEY PAUL J <br />Tanant: <br />Proposed Use: SINGLE FAMILY RESIDENCE <br />Desc. of Work: <br />ADDITION <br />Owner <br />OFFICE SET JOB SET <br />Public Works Permit <br />Bldg. Dept.. <br />Public Works Fee S <br />Total Fee <br />Lass Appl Fee Paid $ <br />Balance Due $ <br />Zip Phone <br />Applicant APPRVD FOR PERMIT: DATE_/_/_ BY_ZipPhone <br />Describe Proposed Work <br />Project Address (if known) <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: <br />• Property Lines • Centerline of street <br />• Outline and dimensions of all existing and • Indicate North <br />proposed structures on the lot - • Show any proposed grading changes <br />• Existing and proposed utilities • Show measurements <br />PERMIT CONDITIONS <br />1. All calls for inppection shall be made 24 hrs. in advance - phone 259.8810. <br />2. All work shall be performed in accurdance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800-424-5555. <br />Approved for Construction <br />FINAL INSPECTION <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone: 259-8810 <br />JRLIC WORKS PERMIT <br />NOT REOUIRED <br />BY <br />DATE <br />Date <br />ACKNOWLEDGEMENT OF CONDITIONS <br />Im <br />O <br />n <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City of Everett from any and all claims for damages, costs, <br />expenses, or causes of action that may arise because of installation <br />and maintenance of the improvement or other right-of-way use hereto <br />applied for and further agrees to remove same upon notice from the <br />City and to replace public property damaged thereby. <br />Signature of Applicant <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER 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 DURATION. <br />