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� \pplication fror ,,- . <br /> PUBLIC�vJORKS PERMIT °��.� <br /> PUBLIC WORKS DEPARTMENT Puhlic Wcrks PermR N <br /> 3200 Cedar Street <br /> Everett,WA98201 259-8810 Bullding PertnkN <br /> 6 <br /> TYPE OR ''RINT OtdLY au6ltc Works Fee S <br /> Plan Check No: C 60345 SEPA <br /> Applicat.Date: 09/28/98 <br /> Owner Job Addreae: 8922 5TH AVE W Phone <br /> Owner: LUNDQUIST STEVE/liENORE <br /> Tenant: <br /> Propoaei Uae: SII7GLE FAMILY R'c'SIDENCE <br /> Applicant Desc. of Work: Phone <br /> ADDITION <br /> Describe Proposed Work_ apFIce SET ,JOB S4.'T � <br /> APPROVED FOR PEAMIT: DATE__/_/_ BY � <br /> �w <br /> w/ <br /> PROJECT ADDRESS(if known) � <br /> Attach four(4)wpies of pians for proposed work-Draw to scale and nnte the lollowing N appllcable: <br /> •Property Lines 'Outline and dimensions of all exisling and pr�posed structures on the lot •Fxisting and pmposed utilities O <br /> 'Centerl(ne of street •Indicate North 5how any proposed grading changes •Show measurements � <br /> DO NOT WRITE BELOW THIS UNE <br /> PERMIT CONDITIONS: � <br /> 1.All calis for inspection shall be made 24 hours in advance-pFrone 259-8810. O <br /> 2.All work shall be performed in aocordance with this permit and current City of Everett Design and <br /> Construction Standards anc! Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you di�. TOLL FREE NUMBER 1-800-4245555. H <br /> ''UilI.IC WpRKS PERM�� �/� <br /> hOT OUIREP� �Ir <br /> �Y _-_ O <br /> .ATF. --- -:��.�� a <br /> � <br /> ` ACKNOWLEDGEMENT OF CONDfTIONS <br /> � The undersigned ownedapplicant hereby agrees to hold and save harmiess <br /> the Ciry of Everett from any and all elaims for damages,costs,expenses,or <br /> Approved(or Construction Date causes of adfon that may arise because oi installation and maintenance of <br /> the improvemen�.orother righbol-w,iy use hereto app9ed forand fuAher agrees <br /> lo remove•same upon notice frm the Cily and to replace public pmperty <br /> dartiaged thereby. <br /> FINAL INSPECTION Date <br /> Appro��ed as Constructed <br />, Signature of Applicant Data <br /> WORK AUTHORIZED 8Y THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMR IS ISSUED AND THERFAFfER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLETION.THIS PERMR MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON TH�S PR0.IECT OVER 90 DAYS OURATION. <br />