Laserfiche WebLink
NPE OR PRINT ONLY <br />Owner <br />Applicant <br />Describe Proposed Work <br />�Iicauon For <br />PUBLIC ORKS PERMIT <br />PUBLIC N/ORKS DEPAFiTMENT <br />3200 Cedar Street <br />Everett, WA 98201 259-8810 <br />---� .�r�s- � rx D2 W <br />Plan Check No: C 61753 SEPA <br />Applicat.Date: 03/03/99 <br />Job Addrees: 75b�`"7TH DR W <br />Owner: OTTERSON ICEVIN <br />Tenant: <br />Propoeed Uee: SINGLE FAMILY RESIDENCE <br />Deec. of Work: <br />ADDITION OF MASTER HEDROOH AND BATH <br />OFFICE SET JOB SET <br />APPROVED FOR PERHIT: DATE_/_�_ gy <br />PROJECTADDRESS (if known) <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the lollowing if applicable: <br />�, <br />Date <br />Public Works Pertnit N <br />Building Permit N,_ <br />Public Worl:s Fee $ _ <br />Phone — <br />�Property L1nes •Outline and dimensions of all exfsting and proposed structures on the lot •Existfng and proposed utilities <br />•Centerline of street •Indicate North •Show any proposed grading changes •Show measurements <br />UO NU I WHf1 E BELOW THIS LINE <br />PERMIT CONDITIONS: <br />1. All calis for inspection shall be made 24 hours in advance - phone 259-8810. • <br />2. All work shall be performed in acco;dance with this pertnit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TO�L FREE NUMBER 1-800-4245555. <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />+1J1iLIC YJURI<S PERh!�"� <br />r:or �q��Uut�e� <br />!iY.�.�.-µ.�.+. �_. <br />� �T f: . .r ,,_._3.����-�--.. <br />� <br />� <br />�i/� <br />V♦ <br />O <br />a <br />ACKNOWLEDGEMENTOF CCNDITIONS <br />The undersigned ownedapplicant hereby agree:� to hoid and save hartnless <br />the Ciry of Everett (rom any and all claims for damages, costs, expenses, or <br />causes of actlon that may arise because of Inshillallon and maintenance of <br />the improvement or other r.'ght-of-way use hereto applied for and further agrees <br />to remove• same upon notice 6om the City and to repiace public properry <br />damaged lherehy. <br />Signature of Applicant Gate <br />WORK AUTHORIZED BY THIS PERMR MUST BE STARTED WITHIN �180 DAYS OF DATE PERMIT IS �SSUED AND THEREAFfER IS TO BE OILIGENTLY PURSUED TO <br />COMPLEi70N.'fH15 PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WQRK ON hIIS PROJECT OVER 90 DAYS DURATION. <br />