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❑+calron For <br />PUBLIC �1FORKS PERMIT <br />TYPE OR PRINT ONLY <br />Owner <br />Applicant <br />Describ- Proposed Work <br />PROJECT ADDRESS (if known) <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 259.8810 <br />rn POSTING, ""p " <br />DatA <br />Public Works Permit e <br />Building Permit a <br />Public Works Fee S _ <br />Plan Check No: B 54537 SEPA <br />Applicat. Date: 03/%97 <br />Job Address: 306 9 ND ST SE <br />Owner: BLAKE CLYDE W <br />Tenant: <br />Proposed Use: SINGLE FAMILY RESIDENCE <br />Desc. of Work: <br />FAMILY ROOM ADDITION <br />OFFICE SET_ JOB SET_ <br />APPROVED FOR PERMIT: DATE_/_/ <br />BY <br />Attach tour (4) copies of plans for proposed work - Draw to stale and note the following if applicable: <br />•Property, Unes *Outline and dimensions of all existing and proposed structures on the lot 'Existing and proposed utilities <br />*Ce, terline of street *Indicate North *Show any proposed grading changes *Show measurements <br />NOT WRITE <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 />pjbI f(, Works <br />C&-Cl s <br />lC MA OU✓I L446C-Y- Ir fL <br />c4a i LC0.1 <br />PIPt/-tD UPC. L/O zGC JLlI. <br />Approved for Construction Dale <br />FINAL INSPECTION Date <br />Approved as Constructed <br />Is <br />D <br />z <br />V♦ <br />O <br />M <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 JF WC -AK ON THIS PROJECT OVER 90 DAYS DURATION. <br />