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PuEnc Works Parmit• <br /> Date e.�a oen�.• <br /> Applicatlon For <br /> PERMIT PublicWo�kaFee s <br /> pUBLIC WORKS TotelFee <br /> Leas Appl Fee Peitl S <br /> Balence Oue S�— <br /> Print or Type Only <br /> Plan Check No: B 42223 SEPA <br /> Applicat.Date: 10/O1 93 <br /> Job Addre: 6627 G TEWAY TERRACE phane <br /> Owner: WEEKS EVERETT Zip , <br /> Owner Tenant: <br /> Propoeed Use: GARAGE <br /> Deec. of Work: <br /> REPLACEMENT GARAGE ZiP Plione <br /> APPlicant <br /> OFFICE SET JOB SET <br /> Describe Proposed Work ApPRVD FOR PERMIT: DATE_/_I_ BY <br /> � <br /> _ � <br /> Prolect Address(il known) � <br /> Attach four(4)copies ot pla�s for proposed work• Draw lo scale and note�Ceniterline ot sUeel aF,�e. � <br /> • Property Lines • Indicate Norlh <br /> • Outline and dimensions of all existing and � Show any proposed grading changes <br /> proposed structures on the lol � Show measurements M <br /> • Existing and proposed utiiities W <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS � <br /> 1.All calls for inspeclion shall be made 24 hrs.in advance•phone 259-8810. <br /> 2.All work shall be peAormed in accordance with this permit and current Cily ot Everett Design and Construction <br /> Stendards and Specifications. � <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800•424-5555. <br /> O <br /> � <br /> � <br /> ;IBUG WOHKS PERMIT O <br /> NOT REOUIRED <br /> LY a <br /> :�ATE 9 <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm• <br /> less the City of Everelt Irom any and all claims for damages, cosls, <br /> expenses, or causes of action that may arise because ol installation <br /> and maintenance of Ihe improvemenl or other right•of•way use hereto <br /> app�ied for and lurther agrees to remove same upon notice irom the <br /> Approved for Construction <br /> Date City a�d lo replace public property damaged thereby. <br /> Date licanl Dale <br /> FINAL INSPECTION Signature ot APP' <br /> ppproved as Constructed WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> PUBLICWORKSDEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> ���� 3200CedarStreet BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY 8E <br /> Everelt,WA 98207 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259•8810 PROJECT OVER 90 DAYS DURATION. <br />