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P-bft Wok•Perm" <br /> ApplicatiS r or 9efa Dept a <br /> PUBLIC WORKS PERMIT ftb% ;;f•• , <br /> Leu•PPw Pee Paid 3 <br /> Print or Type Only Balance Due $ <br /> Plan Check No: C 4/91.11:1 StYA <br /> Owner Appllcat.Datet 03/31/95 Phone <br /> Job Address: 2242 60TH ST <br /> Owner: LOSO ROBERT <br /> Tenant: <br /> Applicant Proposed Use: SINGLE FAMILY RESIDENCE Phone <br /> Desc. of Work: <br /> REMODEL OLD STORE AND HOUSE INTO A SINGLE <br /> Describe Proposed Work FAMILY HOUSE WITH 1 CAR GARAGE <br /> OFFICE SET JOB SET <br /> APPROVED FOR PERMIT: DATE_/V/_ BY <br /> W <br /> Project Address(If known) <br /> Attach four(4)copies of plans for proposed work-Draw to scale and note the following as applicable: <br /> • Property Lines • Centerline of street <br /> • Outline and dimensions of all existing and • Indicate North <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS <br /> 1.All calls for inspection shall be made 24 him in advance-phone 259.8810. O 0 <br /> 2.All work shall be performed In accordance with this permit and current City of Everett Design and Construction <br /> Standards and Specifications <br /> 3.Call Location Underground Service 48 hrs before you dig.TOLL FREE NUMBER 1.800.424.5555. z <br /> 0 <br /> eURLIC WORKS PERIJIT <br /> NOf REOUIREP <br /> Fly -720 <br /> CIO <br /> ti ATE YS <br /> 0 <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br /> less the City of Everett from any and all claims for damages, costs, <br /> expenses, or causes of action that may arise because of installation <br /> and maintenance of the improvement or other right-of-way use hereto <br /> applied for and further agrees to remove same upon notice from the <br /> Approved for Construction Date City and to replace public property damaged thereby. <br /> FINAL INSPECTION Dale <br /> Approved as Constructed Signature of Applicant Dale <br /> PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200 Cedar Street 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS .TO <br /> Everett,WA 98201 RE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:259.8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />