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Date__ <br />Applicatlon For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Owner <br />Applicant <br />Describe Proposed Work _ <br />Pro�ect Address (if known) <br />Plan Check No: B 47988 SEPA <br />Applicat.Date: 04�06/95 <br />Job Addreee: 80 2 BEVERLY LANE <br />Owner: MALTOS PEDRo <br />Tenant: <br />Propoeed Uee: GARAGE <br />Desc. of Work: <br />NEW GARAGE <br />OFFICE SET JOB SET <br />APPROVED FOH PERMIT: DATE_/_/_ BY <br />Pu01ie Work� P�rmll • <br />B�dp.DaO� � - <br />Publie WorMa f�� <br />Tolal Fa� s <br />Uu AOG� Fa� Pa1E $ <br />B�IanC�Dve S <br />ip Phone <br />Ip Phone <br />Attach lour (4) copies of plans for proposed work • Draw to scale and note Ihe 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 prnposed utllities • Show measurements <br />PERMIT CONDITIONS <br />1. All calls for tnspection 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 Everelt Design and CanstNctlon <br />Standardsand SpedHcaHona <br />3. Call Location Underground Servica 48 hrs 6efora you dlg. TOLL FREE NUMBER 1•800•424•5555. <br />PUB �10TWREOUIREO MIl <br />�v_�a <br />�� AT E _. � � �9 t <br />�— — <br />Approved lor ConstrucUon Date <br />FINAL INSPECTION Dale <br />Approved as Conslructed <br />�A�a�PUBLIC WORKS DEPARTMENT <br />3200 Cedar Streel <br />Everet4 WA 98201 <br />Phone: 259�0610 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />H <br />�1 <br />_ / <br />� <br />O <br />The undersigned owner/applicant hereby agrees lo hold and save harm- <br />less the City ol Everett Irom any and al� claims for damages, costs, <br />e:penses, or causes of actlon that may arise because of instaltation <br />and maintenance oi Ihe improvement or other ri�,7hl•of•way use hereto <br />appiied for and lurther agrees to remove same upon notice Irom the <br />City and to replace public property damaged Ihereby. <br />Signature ol Appllcant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSU'cD AND THEflEAFfER IS �TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CI"fY UPON ANY STOPPAGE OF WORK ON THIS <br />PFOJECT OVER 90 DAYS DURATION. <br />