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YPE OR PRINT ONLY <br />Owner <br />Applicant <br />A alron For <br />PUBLIC W r�KS PERMIT <br />7escribe Proposed Work <br />PUBLIC WO^.KS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 259-BB10 <br />Plan Check No: C 58515 SSPA <br />Applicat.Date: 04/14 98 <br />Job Addrees: 85b7 TH AVE SE <br />Ownez: PITTSENBARGER SRENT <br />Tanant: <br />Propoeed Uee: SINGLE FAMILY RESIDENCE <br />Deec. of Work: <br />ADDITIONS AND REMODEL <br />OFFICE SET JOH SET <br />APPROVED FOR PERMIT: DATE_/_/_ $Y <br />�RO;IECT ADDRESS (if known) <br />�ttach lour (4) copies of plans for proposed work - Uraw to scale and note lhe foltowing it applica6le: <br />Oate �. i <br />Public Warks Perm011 _ <br />Butlding Permit I <br />Public Nbrks Fee S <br />Phone <br />Phone <br />•Property Lines •Outline and dimenslons of all existing and proposed stnutures on the lot •Existing and proposaC utilNles <br />•Centerline ol street •Indicate Nonh •Show any proposed greding changes •Show measurements <br />PERMIT CONDIT6GNS: <br />1. All calls for inspection shall be made 2? hours in advance - phone 259-8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. C.ail Location Underground Service 48 hrs. before you diy. TOLL FREE NUMBER 1-800-424-5555. <br />�x;� <br />a��;�,� <br />"UDLIC WORKS ��,►}�;� <br />�vOi 6UIi1611 <br />tY__._ � <br />r <br />*A � E _ _� Z, -- -- 1) <br />S�Gtt�1r' I �M$ </►'tC�J�JY' Gne'A' �T (dt'0 <br />- S;d<<,��.�.r w�' bt C.��N� -i-� w�.' <br />JpL, ,�vtz,�-,t.�,�:t r��n�e.r.�.ar <br />Approved lor Construction Date <br />FINAL INSPECTION Date <br />Approved as Constmcted <br />ACKNOWLEDGEMENTOFCONDRIONS <br />The undersir.ned owner/�ppticant herehy agrees to hold and seve hertnksa <br />the Clty of Evereli trom any and all claims tor damages, costs, expensea, or <br />causes of actlon that may erise :+ecause of Installatbn and mainlananea of <br />the improvement or other rigM-or-wey use hereto applied lor end furtMr agroaa <br />to remove same upon notice trom the Ctty end to roplacs publfe propeAy <br />damaged thereby. <br />Signature of Appllcant Dat� <br />NORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WiTHIN 1B0 DAYS OF DATE PERMR IS ISSUED AND THEREAFfER IS TO BE DILIGENiLY PIiASUEO TO <br />:OMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PRQIECT OVER 80 OAYS DURATION. <br />