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Date <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only Plan Check NO: U 46167 SEPA <br />Applicat.Date: 11/08/94 <br />Job Address: 8114 BEVERLY BLVD <br />Owner: MORAN 14ARION <br />Tenant: <br />Proposed Use: SINGLE FAMILY RESIDENCE <br />Owner Desc. of Work: <br />PATIO COVER <br />Public Works Permit <br />Bldg. Debt. e - <br />Public Works Fee s <br />Tidal Fee <br />Less APPr Fee Paid If <br />Balance Due $ <br />:ip Phone <br />OFFICE SET JOB SET <br />Applicant :ip Phone <br />APPROVED FOR PERMIT: DATE_/_/_ BY <br />Describe Proposed Work _ <br />Prn)ect 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 />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 Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800.424.5555. <br />.71.181.IC WORKS PERMIT <br />Nor REOUIRER <br />4' Y <br />ATE 7Z <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Ceder Street <br />Everett, WA 98201 <br />Phone: 259.8810 <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 fir 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 Dale <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 />PROJECT OVER 90 DAYS DURATION. <br />