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, <br /> alicatwn For <br /> PUBLIC �ORKS PERMIT Da� <br /> � PUBLIC WORKS DEPAFfTMENT Public Works Permit# <br /> 3200 Cedar Slreet <br /> Everett,WA 98201 259-8810 Building Pertnit N <br /> �TYPE OR PRINT ONLY Piihlir.Wnrks Fee S <br /> Plan Check No: B 53907 SEPA <br /> Applicat.Date: O1/09/97 <br /> Job Addreee: 23i5 6TH ST Phone <br /> Owner Owner: FANCHER CHARLES <br /> Tennnt: <br /> Propoeed Use: SINGLE FAIiILY RESIDENCE <br /> Deec. of Work: <br /> Applic�.; � ADDITION TO HATHROOM Phone <br /> Describe Proposed Work_ oFFICs seT Joa sET � , <br /> APPROVED FOR PEAMIT: DATE_/_/_ BY � <br /> _ � <br /> �/ <br /> PROJECT ADDRESS (if known) M <br /> W <br /> Atlach four(4)copies of plans lor proposed work-Draw to scale and note the following ii appiicable: O <br /> •Property Lines •Outline and dimensions of all existing and proposed struciures on ihe lot •Existing and proposed utilities <br /> •Centedine of street •Indicate North 'Show any proposetl grading changes •Show measurements � . <br /> 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 he 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 /> �v ��Il� VJ�� �,�1��'�J,�� • p <br /> � <br /> a <br /> ACKNOWLEDGEMENT OF COND�TIONS <br /> The undersigned owner/applicant hereby agrees to ho�d and save harmless <br /> the City of Evereri trom any and all claims for damages,costs,ezpenses,or <br /> Date causes ol action that may arise because of installation and maintenance of <br /> Approved for Construction the impiovemenl or olher right-ol-way use hereto applied tor and(uAber agrees <br /> to remove same upon notica from lhe City and to replace pu6iic property <br /> damaged thereby. <br /> FINAL INSPECTION Dale <br /> Approved as Consimcted <br /> Signature of Applicant Oate <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND 7HEREAFfER IS TO BE DILIGENTIY PURSUED TO <br /> COMPLETION.THIS PEfiM1T MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />