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:t e ,--w <br /> . � � Pu01le Waha Pvmil� �� <br /> Applicatlon Por emo-o•o�. <br /> PUBLIC WORKS PERMIT �����W��,F.. <br /> .o�.�F.. s <br /> �����oo�Fer Pala S�� <br /> Print or Type Only e,�.��.o�. s <br /> Plan Check No: H 47685 SEPA <br /> Applicat.Date: 03 08/95 <br /> Job Addre: 480 FOREST DR <br /> Owner Owner: ELLIS MARK <br /> Tenant: Phone � <br /> Propoeed Uee: SINGLE FAMILY RESIDENCE <br /> Desc. of Work: <br /> CONSTRUCT ATTACHED GARAGE AND SHOP/STORAGE <br /> Appllcant Phone <br /> OFFICE SET JOB SET <br /> Descrlbe Proposed Work _ APPRVD FOR PERMIT: DATE_/_/_ BY <br /> Project Address(if known) � <br /> Attach tour(4)copies of plans for proposed work-Draw to scale and note the following as applfcable: � <br /> • Property Lines • Centerline ot street � <br /> • Outline and dimensions oi all exiating and • Indicate North <br /> proposed structures on the lot � Show any proposed greding changes <br /> . � Existing and proposed utllities • Show measurements <br /> DO N(.T WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS O <br /> 1.All calls for inspectbn shall be made 24 hrs.in advance-phone 259•881 O. � <br /> 2.All work ahall be peAormed in accordance with this permit and current Cfty of Everett Design and Conatruction <br /> Standards and Speciflcationa � <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800-4245555. � <br /> O <br /> 'UBLIC WORKS PERAIIT � <br /> • 'Y� REOUIREB � <br /> �ATE / S O <br /> a <br /> I V � ACKNOWLEDGEMENTOFCONDITIONS <br /> ( The undersigned owner/appiicant hereby aqrees to hold and save harm- <br /> less the City of Everett (rom any and all claims for damages, costs, <br /> expenses, or causes of action that may arise because of installation <br /> _ and maintenance of the improvement or other riaht-of•way use herelo <br /> Approved for Construct(on applied for and further agrees to remove same upon notice trom the <br /> Date City and to replace public property damaged thereby. <br /> FINAI INSPECTION Date <br /> Approved as Constructed S�gnature of Applicant Dale <br /> PUBLIC WORKS DEPARTMENT WORK AUTHORIZEO BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CedarStreet 180 DAYS OF DATE PEqMIT IS ISSUED AND TfiEREAFTER IS �TO <br /> Everet�WA98207 BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Phone:259-8810 CANCEILED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />