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Application For <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 (425) 257.8610 <br />TYPE OR PRINT ONLY <br />Owner <br />Applicant <br />Describe Proposed Work _ <br />Plan Check No: <br />Applicat.Date: <br />Job Address: <br />Owner: <br />Tenant: <br />Proposed Use: <br />Desc. of Work: <br />NEW DP.TACHED <br />OFFICE SET <br />Dery <br />Public Works Permit R <br />Building Permit H _ <br />Public Works Fee $ - <br />B 62786 SEPA <br />06/18/99 <br />17 W BEECH ST <br />ESTRADA JODEEN <br />GARAGE <br />GARAGE <br />JOB SET___-_ <br />APPROVED FOR PERMIT: DATE _/_/_ <br />Phone <br />Phonu <br />W <br />tttttt� <br />PROJECT ADDRESS (if known) — 0 <br />O^ <br />Attach four (4) copies plans for proposed work - Draw to scale and note the following If applicable: <br />• Property Lines • Outline and dimensions of all existing and proposed structures on the lot • Existing and proposed utilities <br />• Contedine of street • Indicate North • Show an,� proposed grading changes • Show measurements <br />DO NOT WRITE BELOW THIS LINE <br />PERMIT CONDITIONS: O <br />1. All calls for inspection shall be made 24 hours in advance - phone (425) 257-8810 <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and <br />Constriction Standards and Specifications.. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-80D-424-5555. <br />CIO <br />�UDLIC WORKS PERMIT O <br />NOT EJ A <br />IR - <br />Y-----I a <br />OATF. <br />Approve or Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />ACKNOWLEDGEMENT OF CONDII IONS <br />The undersigned owner/applicant hereby agreus to hcFi 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 end maintenance of the <br />Improvement or other right-ol-way use hereto applied lot and tunher agrees to <br />remove same upon notice from the City and to replace public property dam- <br />aged thereby. <br />;gna ure of Applicanta e <br />WORK AUTHORIZED BY THIS PERMIT MUST UE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PUHSUtU IU <br />COMPIXT ON. IHIS PERMIT MAYBE CANCELLED BY THE CrTY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 971 DAYS DURATION. <br />