114 FOREST CT 2016-01-01 MF Import

� ^'Plication For - PUBLIC 1rrORKS PERMIT °a PUBLIC WORKS DEPARTMENT Public Works Permit# 3200 Cedar Street Everett,WA 98201 259-8810 Building Permit k TYPE OR PRINT ONLY ''s Fee$ Plan Check No: B 52970 SEPA Applicat.Date: 09/23/96 Job Addrese: 114 FOREST COURT �� Owners BARER BROCK phone Tenant: - Propoeed Uee: GPSSAGE Deec. of Work: � SLAB FOR FUTURE GARAGE Applicant Phone OFFICE SET JOB SET ; DBSCfIL'19 PropOSBd WOfk_ APPROVED FOR PERMIT: DATE_/_/_ BY W � � � � PROJECT ADDRESS(if known) M ,. Attaeh tour(4)coples of plans for proposed work-Draw to scale and note the following if applicab�e: �i+ ! 'Property IJnes 'Outline and dlmensions ot all exlsting end proposed structuras on the lot •Existing and proposed utilities O ,' 'Centerline of ffiraet 'Indicate North 5how any proposed grading changes 5how measurements � ' DO NOT WRITE BELOW THIS LINE � PERMIT CONDITIONS: Z � 1.All calis for in�pection shall be made 24 hours in advance- phone 259-8810. � 2. All work shall be perfortned in accordance with this permit and current City of Everett Design and O � Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � ' �� bl �� W/�rkS ��.rm�� n��- I�e��red. N � 0 a ACKNOWLEDGEMENT OF CONDITIONS The undersigned ownedappl(cant hereby agrees to hoid and save hartnless the Clry of Everett from any and all claims for damages,costs,ezpenses,or Approved lor Construction Date causes of action that may arise because of installatfon and maintenence of the Improvement or other rightrof-way use hereto applled ta and iurtheragrees to remove same upon notice from the City and to replace public properry damaged thereby. FINAL INSPECT70N Date �"� qpproved as Constructed Signature o}Applicant Dale WORK AUTHORIZED BY THIS PERMIT MUST BE STAHTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLEf10N.THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.