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� PI�BLIC 1�.ORKS PERMIT °��^ <br /> PUBLIC WORKS DEPARTMENT �Publlc Works Pertnit# <br /> 3200 Cedar Street <br /> Everett,WA 98201 259-8810 Building Pertnit�M <br /> TYPE OR PRINT ONLY Public Works Fee$ <br /> �''^� N Plan Check No: B 5/1797 ggpp Phone <br /> APPSobBAddree�43322FOREST DR <br /> Owner: LAMPI DON <br /> Appikant ti Tenant: Phone <br /> ?rapoeed Uae: GARAGE (SFR) <br /> Desc. of Work: <br /> Describe Proposed Work NEW DETACHED GARAGE � <br /> OFFLCE SET J08 SET � <br /> � APPR'JD FOR PERMIT: DATE_/_/_ g� � <br /> _ �/ <br /> PROJECT ADDRESS(if known) � <br /> Attach four(4)coplea of plens for proposed work-praw ta scnle and note the following if applkable: , <br /> 'Property Lines �putline and dimenslons ot all existing and proposed s[ructures on the bt •Existing and proposed utlllties O� <br /> 'Centerline of street •Indlcate North 'Show any pnposed greding changes 5how measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspection shall be made 24 huurs in advance-phone 259-8810. O <br /> 2.All work shall be performed in accordance�vith this permit and currerrt City of Everett Design and <br /> Construction Standards and Specifications. � <br /> 3.Call Location Underground Service 48 hrs. before you dig. TOLI FREE NUMBER 1-800-424-5555. � <br /> V♦ <br /> ' O <br /> "UBUC WOflKS PEpMIY a <br /> �iOT ji�OUIREP <br /> 3Y_�fl <br /> �ATE_ S_Z3 `f(o <br /> . ACKNOWLEDGEMENT OF CONDI110NS <br /> The undersigned owner/applicant hereby agrees to hdd and save harmless <br /> the Clty of Everett hnm any and all cla(ms for damages,costs,expanses,w <br /> Approved tor Construction Date wuses of aetlon that may arise because of Installation and maintenance of <br /> the tmprovement or other right-of-way use hereto epplied for arM further agrees <br /> to remove same upon noNce from the City and to replace public property <br /> damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed <br /> Signature of Appllcant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STAFiiED WIhIIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGEN7LY PURSUED TO <br /> COMPLEiION.THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />