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Date <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Owner <br />Appltwnt <br />Describe Proposed Work <br />Prolect Address (il known) <br />Plan Check No: B 46705 SEPA <br />Applicat.Date: Ol/11/95 n..F,�., <br />Job Addra: 5008 LABT'�tp " <br />Owner: CAIN JAMES P <br />Tenant: <br />Proposed Use: GARAGE (SFR) <br />Desc. of Work: <br />F1EW DETACHED GARAGE <br />Pv01ie Work� Permil • <br />eiaq. oeoi • _ <br />aueuc worb Fee <br />ToblFee S <br />Len ApO� Fee PaiO S <br />8aunce Due S _ <br />OFFICE SET JOB SET ' <br />APPRVD FOR PERMIT: DATE_�_�_ gy - <br />Attach fo•er (4) copies of plans for proposed work • Oraw to scale and rote the I011owing as applicable: <br />• Property Lines • CenteAine of street <br />• Outiine and dimensions of ail ezisting and i indicale North <br />proposed structures on Ihe Iot • Show any proposed grading changes <br />• EzisNng and proposed utililies • Show measurements <br />Phone <br />Phone <br />PERMIT CONDITIONS <br />1. All calls tor inspection shall be made 24 hrs, in advance • phone 259•8870. <br />2. All work shetl be performed in accordance with ihis permit and current City of Everett Design and Construction <br />Standards and Specificetions. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•$00•424•5555. <br />�UBLIC WORKS PEPMIy <br />h�� REqUIRE� <br />Ay�� <br />�eATE /' � --� <br />Approved for Construction Date <br />FINAI. INSPECTION Date <br />Approved as Construct=d <br />' PUBLIC WORKS DEPARTMENT <br />3200 Cedar Streel <br />Everett, WA 98201 <br />Phone:259�8870 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm• <br />less Ihe Cily ol Everelt Irom any and all ctaims for damages, costs, <br />expenses, or causes ol action that may arise because of insfal�ation <br />and mainlenance ol the improvement or o�her right-of-way use hereto <br />app�ied for and further agrees to remove same upon notice from the <br />City and to replace public property damaged fhereby. <br />Signature ol Applicant Dale <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTcD WITHIN <br />180 DAYS OF DATE PEfiM,IT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGC-NTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANGELLED BY THE CITY UPON ANY STOPPAGE OF WOFK ON THIS <br />I'ROJECT OVER 90 DAYS DURATION. <br />