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Date <br />Applica ion For <br />PUBLIC WOI;KS PERMIT <br />Print or Type Only plan '.heck No: B 42822 SEPA <br />Appli�at.Date: 11/29/93 <br />Job Addre: 7508 7TH DR W <br />Owner: RODRIGUEZ JESUS <br />Tenant: <br />Owner Prop�iaed Use: SINGLE FAMILY RESIDENCE <br />Desc. of Work: <br />REMOJEL <br />Applicant <br />Describe Proposed Work _ <br />Proiect Address (if known) <br />OFF'ICE SET <br />SET <br />APPRVD FOR PERMIT: DATE_/_/_ BY. <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following as 3pplicable: <br />• Properry Lines <br />• Outline and dimensions of all existing and <br />proPosed structures on the lot <br />• Existin9 and proposed utilit�as <br />Pu011c Works Parmil • <br />B�tlg. Dept. s _ <br />Puolic wo�ks Fco $ <br />Total Fce <br />Less AOaI. Fee PaiC $ <br />Balance Dua � <br />• Centerline of street <br />• Indicate Norih <br />• Show any proposed grading :hanges <br />• Show measurements <br />Phone <br />PERMIT COWD;"f�ONS <br />1. All calls fer inspection shall be made 24 hrs. in advance • phone 259•8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br />Standar�s and Speci(icatlons. <br />3. Call Location Under,round Service 48 hrs. hefore you dig. TOLI FREE NUMBER 1-800-424•5555. <br />Approved lor Conslruclion <br />PUBLIC WORKS PERMIT <br />NUT REQUIRED <br />BY � `' <br />DATE ��-z -�3 <br />Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everet6 WA 93201 <br />Phone:259-8810 <br />ACKNO�^�LEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the Cily o( Everett irom any and all claims for damages, costs, <br />ezpenses, or causes of action Ihat may arise because of installation <br />ar.d maintenance of the improvemenl or other right-of�way use hereto <br />applied for and further agrees to remove same upon notice from the <br />City and to replace public property damaged thereby, <br />Signature of Applicant ua�e <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PEqM1T IS ISSUED AND THEREAFTEF IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED 9Y THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />