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� � vlication For — <br /> PUBLIC �. JRKS PERMIT �a1e 4�Z2/96 <br /> PUBLIC WORKS DEPARTMENT Public Works Permit a <br /> 3200 Cedar Street <br /> Everett,WA 98201 259-8810 <br /> Building Permit#_ S 1 S(1G <br /> TYPE OR PRINT ONLY Public Works Fee$ <br /> WAYNE JENSEN 2117 BIGELOW ST SE EVERETT 98203 259-4714 <br /> �'^'�� Mailing Address City Zip Phone <br /> OWNER <br /> Applicant Mailing Atldress City Zip Phone <br /> Describe Proposed Work NEW DETACHED GARAGE <br /> W <br /> H <br /> - <br /> PROJECTADDRESS(ifknown) z117 BIGELOW ST SE � <br /> Attach four(4)copies of plans tor proposed work-Draw to scale and note the following if applicable: � <br /> •Property Lines �Outline and dimensions of all existing and proposed sb��ctures on the lat •Existing and proposed utilities O <br /> `Centerline of street •Indicate North �Show any proposed gredii —^���irements <br /> DO NOT WRITF � <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspection shall be made 24 hours i � <br /> 2.All work shall be performed in accordance witF /� � d O <br /> Construction Standards and Specifications. l;� <br /> 3. Call Location Underground Service 48 hrs. be' (/ ec,�c,�,c. � <br /> I <br /> � '��� p� � � <br /> � � /�/ vn O <br /> "URLtC WORKS PERMIIT " <br /> ri0! REOUIRE4i � � <br /> �Y_�.---- _. N��r��� �nspecrio�v <br /> �aTE_ _____ , KIRK BROOKS <br /> �are __9 -Z9 -9 L <br /> � <br /> iF CONDITIONS <br /> agrees to hold and save harmless <br /> for damages,costs,e�cpenses,or <br /> 4�provetl for Construction Date of inetallation and mainte.n�nca et <br /> hereto applied for and further agrees <br /> �� ��•�� :ity and to replace public proparry <br /> damaged the�eby. <br /> FINAL INSPECTION Date <br /> 4pproved as Constmcted <br /> Signature of Applicarrt Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITIiIN 180 DAYS OF�ATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PUFSUEO TO <br /> COMPLEfION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANV STOPPACaE OF WORK ON THIS PROJECT OVER 90 DAVS DURATION. <br />