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� `- Applicetlon For .�� --- <br /> PUBLIC WORKS PERMIT public Works Pdrtnit M <br /> PUP.LIC WORKS DEPARTMENT <br /> 3200 Cedar Street <br /> Everett,W598201 (425)257-8810 Building Permit k <br /> TYPE OR PRINT QNLY Public Works Fee S <br /> Owner Plen Cheok Nor C 62343 88P71 Phone <br /> Applicat.Date: 05/03/49 <br /> Job 1lddree�: 72b3 �'iTH AVE FT <br /> Owners BROCICSTT CRAI6 F?rone � <br /> Applicent Tensnt: <br /> Fropoead U�at SINGLS PAMILY RS8ID8NCE � <br /> Deec. of worh: <br /> DeSCfIbB PfOpOSBd WOfk _ DBDROOM/DEN ADDITION <br /> OFFICE SET JOH SST � <br /> APPROVED FOR PERMITs D11TE_/_/_ BY �/ � <br /> \I/ <br /> PROJECT ADDRESS (if known) � <br /> O <br /> Attach four(4)copies pla;ta for propased work•Draw to scale end note the following if applicable: � <br /> •property IJnes •Outline and dimensions of all exisNng and proposed structures on the lot •ExisUng and proposed utilitles <br /> •Centedine ot streel •Indicale North •Show�ny proposed gradin9 changas •Show measurements � <br /> DO NOT WRITE BELOW THIS LINE I <br /> PERMIT CONDITIONS: O <br /> 1. All calls for inspection shall be made 24 hours in advance- phone (425) 257-8810 <br /> 2. All work shall be periormed in accordance wiih this permit and current City of Everett Design and � <br /> Construction Standards and Specifications., � <br /> 3. Call Location Underground Service 48 hrs. before you dig.TOLL FREE NUMBER 1-800-424-5555. <br /> O <br /> a <br /> 'UDLIC WORKS �ERMI7 <br /> �OOT E UIREl� <br /> :Y_�� , <br /> •ATF,��5�r�I� <br /> I= Y <br /> ACKNOWLEDGEMENTOFCONDITIONS • <br /> The undersigned owner.'eppiicant hereby agrees M hold ard save harmless <br /> the Clly of Everett from eny end all claims for demeges,cosb,expenses,or <br /> causes of ectlon thet mey arise beceuse of installatlon end meintenar�ce of the <br /> prove or s ru ion e e improvement or aMier ripht�of-way use hereM applied for end further agrees ro <br /> rertwve same upon notice from the Gty and ro replace Publb proPerA'dem- <br /> eged thereby. <br /> FINAL INSPECTION Dete <br /> Approved as Constructed <br /> igne re o <br /> WORKAUTHOR�D BY 7HIS PERMff MUST BE STAFTTID WfT}iIN 18U DAYS OF DATE PERI`ftT IS 6Sl�DMO iFEREAF7ER IS TO BE DlJ09dILY PUFL9UED TO <br /> COMf'LE'TKNJ.iHIS PERMfT MAY BE CANCEILED BYTFE CfTY IRON ANY STOPPAGE OF WOFiC ON THS PFiO.ECT OVER 90 DAYS DURAlId�l <br />