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vpl¢ation Foi <br />PUBLIC 1►.0RKS PERMIT <br />TYPE OR PRINT ONLY <br />Owner <br />Applicant <br />Describe Proposed Work _ <br />PROJECT ADDRESS (if known) <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett. WA 982C1 259-8810 <br />Plan Check No: C 53956 <br />Applicat.Date: 01/15/97 <br />Job Address: 6231 BEECH ST <br />Owner: GOSH ROSE <br />Tenanc: <br />Dat, <br />Public Works Permits <br />Building Permit s <br />Public Works Fee $ <br />SEPA <br />Phone <br />Proposed Use: SINGLE FAMILY RESIDENCE <br />Deec. of Work: <br />CONSTRUCT ATTACHED GARAGE 6 LAUNDRY ROOM <br />ADDITION <br />OFFICE SET JOB SET <br />APPROVED FOR PERMIT: DATE_/_/_ BY <br />Attach four (4) copies of plans for proposed w xrk - 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 />'Centerline of street elndicatc North 'Show any proposed grading changes •Show measurements <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 />,N0 Puw,C earks 4b,4 iG�vj. <br />Approved for Construction Date <br />FINAL INSPECTION Date -., <br />Approved as Constructed <br />O <br />LW <br />■ <br />ca <br />0 <br />00) <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 OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />