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Date <br />Applica!ian For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Plan Check No: C 45707 SEPA <br />Owner Applicat.Date: 09/29/94 <br />Job Address: 2214 7TH ST <br />Owner: DUNCAN DAVID <br />Tenant: <br />Applicant Proposed Use: SINGLE FAMILY RESIDENCE <br />Desc. of Work: <br />BEDROOM/BATH ADDN <br />Describe Proposed Work <br />f'roject Address (if known; <br />OFFICE SET J�B <br />APPROVED FOR PERMIT: DATE_/_I_ BY <br />4ttar.h to�r 141 Cooies �>� PIanS lor propoSed wu:K � Drav: to sr.aL7 antl nC�e n��¢ fo�luwing as apUliCablP.: <br />• Properly Lines <br />• Outline and dimensions ol all existing and <br />proposed structures on the lot <br />• Existing and proposed utilities <br />NOT <br />.bi�c work� ?cemii • <br />Oltlq. OcO�. + <br />Pu�l��c Works Fee 5 <br />Tol� I Fee <br />Lesa ao0l Fa¢ PmJ S -- <br />Calance Ooc $ <br />Phone <br />Phone <br />O �enterline ol Street <br />o Indicate North <br />• Show any rr000seA 9ratling changr.s <br />i Show measurements <br />NE <br />FeRM1T CONDITIONS <br />1. All calls for inspection ^hall be made 24 hrs. in advance - phone 259-8810 <br />2. All work shall be peAormed in accordance with this permit and current City ot Everelt Design and Construction <br />Standards and Specilications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800•424•5555. <br />xaved lor Construction <br />�LIC WOHKS PER,MIT <br />NOf REOUIREw <br />i <br />�Y <br />+ATE 9� <br />Dair. <br />lAL INSPECTION � Date <br />�roved as Constructed <br />����PUBLIC WORKS DEPARTMENT <br />3200 Cedar Sereet <br />� Everelt, WA 98201 <br />Phone:259•8070 <br />ACKNOWLEDG[MENT OF CONDITIOPJS <br />The under;igned owner/apPlic2nt hereby agrees to hold and save harm� <br />less the Gty ol Everell irom any and all claims for damages. costs. <br />expenses. or c�uses ol zction that may arise because ol installation <br />and �naintenancC o! the improvement or other righbobway use hereto <br />appi�ei. Ipr and lurther agrees lo remove same upon nolice Irom the <br />Ci!v anr to replace public property damaged thereby. <br />SignaWre ol APPIiCan! Dale <br />WOFY. AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />�90 DAYS OF DATE PERMIT IS ISSUED ANO THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />C.4NCELLEO BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />oRp IFCT pVER 9p [?A�S DURATION. <br />