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Date <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Plan Check No: C 41931 SEPA <br />Owner Applicat.Date: 09/07/93 <br />Job Address: 610 6 TH PL SE <br />Owner: BRANVOLD CLIFFORD <br />Tenant: <br />Applicant Proposed Use: SINGLE FAMILY RESIDENCE <br />Desc. of Work: <br />GARAGE/BATHROOM (SHOWER STALL) ADDN <br />Describe Proposed Work <br />OFFICE SET JOB SET <br />APPROVED FOR PERMIT: DATE_ _/_/_ BY <br />Project Address (if known) <br />Pubhe Work Perm It <br />Bldg Bop: e - <br />Pubbp WOrkr Foe s <br />Total Fee <br />Less eppL Fee Pud S <br />Nitric. Dee S <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 />E <br />Phone <br />Phone <br />PERMIT CONDITIONS <br />1. All calls for 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 Conslructlun <br />Standards and Specifications. <br />3. Cell Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800-424-5555. <br />Approved for Construction <br />FINAL INSPECTION <br />Approved as Constructed <br />PUBLICWORKS EPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone: 259 8B10 <br />PUBLIC WORKS PERMIT <br />NOT HEOUIRED <br />BY ql�� <br />DATE V 9 <br />Date <br />z <br />O <br />O <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 />City and to replace public property damaged thereby. <br />Signature of Applicant uate <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PRO.IECT OVER 90 DAYS DURATION. <br />