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� vdfcatbn Fa � <br /> PUBLIC 1r✓ORKS PERMIT °�a <br /> PUBVC WORKS DEPAFiTMENT Public Works Pertnk N <br /> 3200 Cedar Stieet <br /> Everett,WA 98201 259-8810 Build(ng Pertnk# <br /> TYPE OR PRINT ONLY Publb Works Fee S <br /> Plan Check Nos C 602g0 <br /> Owner APPlicat.Date: 09/21/�8 3SpA Phone <br /> Job Addreee: 2304 6TA ST <br /> Ownecs OLSON JEAPf <br /> Tenant: <br /> A Proposed Uee: SINGLE FHMILY RESZUENCE Phone <br /> ppli„ant Deec, of Work: <br /> CONVERT GARAGE TO FAMILy py� yAUP�pRY RlI, <br /> BAY'H <br /> Describe Proposed Work_ opFics seT W <br /> ��JOB SST <br /> APpROVED FOR PERHiT: DATE_�_�_ HY � <br /> � <br /> _/ <br /> PROJECT ADDRESS(if known) � <br /> Attach tour(4)copies of plans for proposed work-Drew to scal�s and note the following H applicable: <br /> •Property Llnes 'Outline and dimensions of all existing and proposed structures on ihe lot •ExiffiIng and pioposed utilitles O <br />'� 'Centerllna of street •Indicate NoAh •Show any proposed grading changes •Show measurements � <br /> I DO NOT WRITE BELOW THIS LINE <br />, PERMIT CONDITIONS: � <br /> 1.All calls for inspection shall be made 24 hours in advance-phone 259-8810. • O <br /> 2. All work shall be performed in accordance with 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 /> V♦ <br /> O <br /> 'URLIC WORKS �EPn�n � <br /> tSOT EOUIRE� <br /> •)Y__� V� <br /> +AT�S.--- -- °1�-�. <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> - The undersigned owrwr/applicant hereby egrees to hold and savo hartnless <br /> the Ciry of Everett from any and ali claima tor damages,costs,expenses,or <br /> icauses of actlon that may arise because oi Installation and maintenanr,e ot <br /> , ApprovedforConstruction Date tMimprovementorotherright-of-wayusaherMoapplledfaandfurtneragrees <br />� � ro rertave same upon noLce from !he City and to replace public property <br />'I damageO Uiereby. <br /> FINAL INSPECTION Date <br />� Approved as Constructed <br /> Signature of Applkant Date <br /> WORK AUTHORIZED BY THIS PERMIT MU5T BE STARTED WITHIN 180 DAYS OF DATE PERMfT IS ISSUED AND THEREAFIER IS TO BE DILIGENTLY PURSUW TO <br /> COMPLETION.THIS PERMIT AMY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PRO,IECT OVER 90 pAYS OURATION. � <br />