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01-77 Application For <br />PUBLIC WORKS PERMIT Date <br />- <br />PUBLIC WORKS DEPARTMENT Public Works Permit a <br />0200 Cedar Street <br />Everett, WA 98201 259-8810 <br />Building Permit p _ <br />TYPE OR PRINT ONLY Public Works Fee $ <br />Plan Check No: C 59197 SEPA <br />Owner Mailin Applicat.Date: 06'16/98 <br />Phone <br />Sob Address: M 7 ND ST SE <br />Owner: JOHNSON MICHAEL S <br />Tenant: <br />Applo:ant Proposed Use: SINGLE FAMILY RESIDENCE <br />Mailin Desc. of Work: Phone <br />REMODEL <br />Describe Proposed Work <br />_ <br />OFFICE SET JOB SET <br />W <br />APPP`1VED FOR PERMIT: DATE_/_/_ By__ <br />V i <br />DROJECT ADDRESS (if known) <br />\Itach four (4) copies of plans for proposed work - Draw to scale and note the following If applicable: <br />co <br />'Property Lines •Outline and dimensions of all existing and proposed structures on the lot 'Existing and proposed utilities <br />O <br />•Centerfine of street •Indicate North •Show any proposed grading changes "Show measurements <br />DO NOT WRITE BELOW THIS LINE <br />PERMIT CONDITIONS: <br />1. All calls for Inspection <br />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 />O <br />Construction Standards and Specifications. <br />3. Cal( Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />�1 <br />hOh <br />f.� <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Construcled <br />l'UOLIC WORkt !I:RMir <br />NOT ,EUUIREII <br />�Y,r-.- I _ <br />DATE.,._ ...(/� <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 PERMITiS 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 />