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PUBLIC URKS PERMIT <br />PUBLIC VN JRKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 259.8810 <br />TYPE OR PRINT ONLY <br />Date 1 <br />Public Works Permit e <br />Building Permit e <br />Public Works Fee $ <br />_ Plan Check No: C 54977 SEPA <br />_ <br />Owner pplicat. Date: 04 30/97 <br />Job Address: 14 5 63RD ST SE <br />Owner: CROUCH JOE 6 LAURIE <br />Tenant: <br />Applicant Proposed Use: SINCLE FAMILY RESIDENCE <br />Desc. of Work: <br />RENOVATE EXISTING LIVING AREA WITHIN <br />Describe Proposed Work _ EXISTING FOOTPRINT <br />OFFICE SET JOB SET <br />APPROVED FOR PERMIT: DATE_/_/_ BY - <br />PROJECT ADDRESS (if known) <br />Phone <br />Phone <br />Attach lour (4) copies of plans for proposed work - Draw to scale and note the following if applicable: <br />"Property Lines "Outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities <br />•Cenlerfine of street •Indicate North •Show any proposed grading changes "Show measurements <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 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. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />Q6 -R)bi -"; &k, �" od <br />Approved for Construction U:nr• <br />FINAL INSPECTION Date <br />Approved as Constructed <br />W <br />V , <br />Z <br />O <br />Fm/� <br />W <br />Q <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damages, costs, expenses, or <br />causes of action that may arise because of Installation and maintenance of <br />the improvement or other right-of-way use hereto applied for and further agrees <br />to remove same upon notice from the City and to replace public property <br />damaged thereby. <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />