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`. Applkxtbn For <br />PUBLIC Yr�'ORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everetl, WA 98201 (425) 257-8810 <br />TYPE OR PRINT ONLY <br />Owner <br />ApPlicant <br />Describe Proposed Work <br />PROJECT ADDRESS (if known) <br />D�._ <br />Public Works Partnit M <br />Building Permit 8 _ <br />Public Works Fee S _ <br />Plan Ch�ck Nos C 62584 BSP11 <br />11pplicat.Dat�i 05/26 99 <br />3ob l►ddra�e: 716 3 RD ST <br />Own�ri HOLLIHGSE�IID BRI71N <br />Tenants <br />Propoeed Usas SINGLE FAMILY RESIDENCB <br />Do�c. of Work: <br />ADDITION OF DORMER A17D REMODEL ON 2ND lIAOR <br />OFF.T.CS SET JOB SET <br />APPROVED FOR PERMITi D11TS__/_/_ BY <br />Phone <br />Phone <br />Attach lour (4) coples plens lor proposed work - Drew to scale arM note the tollowing if applicable: <br />. Property Lines • Outline and dimenslons of eil existlng and proposed structurea on the Iot • Existlng and proposed utl8tles <br />� Centerline ot street • IMkx�e North • Show any proposed greding changes • Show measurements <br />DO NOT WRITE BELOW THIS LINE <br />PERMIT CONDITIONS: <br />1. All calls for inspectfon shell 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 Design and <br />C�nstruction Standards and Specifications. , <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />?UDL'C WO�KS �6RM1. <br />'i07 EdUIRE.I► <br />tY_� .� _ <br />�ATE._r_.�,� — <br />pr or s ruc on a e <br />FINAL INSPECTION <br />APProved as ConsWcted <br />Dete <br />W <br />� <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />ACKNOWLEDOEMENTOFCONDITIONS • <br />The undersigned owner/applkent hereby aprees b hold and saw hartnless <br />the Ciry ot Everen irom any and dl daima for damagns, cosb, ezparoea, or <br />causes of action that mey ariae be.:auae of inatall�tlon ard matntenance d the <br />improvement or otlier right�ol-way use hereb epplbd 1or arW furmer apreea ro <br />remove sama upon ratice from the Ciy and m replace puWk proporry dem• <br />aged thereby. <br />gne re o p ican <br />WOFiKAUTFIOR� BY 7HIS PERhXi MU5i BE SfAHfID WRHW 7B0 DAYS OF OAiE PEFi�MT IS ISSUED AND i}£fEAF1ER IS Tt� BE DLKiENIIY PURSUF'770 <br />OONPLF(ION. THS PEW�T MAY BE CANCELFD B`( TFf CfTY IN�+ONANY SR�PPAfiE OF Nk7ii( ON iHS PRQECTOYER YO DAYS DUFiAl10K <br />