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/CMr� i�on Fa <br /> i� PUBLIC W��RKS PERMIT Date � � <br /> PUBLIC WORKS DEPAqTA4ENT Public Worka Permit N <br /> 3200 Cedar Strcet <br /> Everatl,WA 98201 259-8810 <br /> Building Permit N <br /> TYPE OR PRINT ONLY <br /> Publie Works Fee S <br /> Plan Check Nos C 58505 SSPA <br /> Owner Ma Appllcat.Date: 04[14(98 � <br /> Job Addr�: 4835 Gr.fiNWOOD AVE Phone <br /> Owner: BERTSCH LARRY D <br /> Tonant: <br /> Applicant Propo��d U��s CARAGB/LIVING <br /> Ma De�c. of Works Phone <br /> CONSTRUCT L'�Tl►CHBD CARAGS WITH �.IVING SP71CS <br /> Describe Proposed Work ABovE <br /> OFFICB SET JOB SET � <br /> APPRVD FOR PERlIIT: D]�TE_/_ _/_ BY � <br /> � <br /> PRO;IECT ADDRESS(if known) � <br /> Attach four(4)copies of plans lor proposed work-Draw to scale and note the folbwing if applicable: m <br /> •Propeity Ltnes •Outline and dimensfons of ali existing and proposed structures on the lot •Existing and proposed utilitles O � <br /> •Centerline ot street •Indicate North •Show any proposed grading changes •Show measurements <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: <br /> 1. All cails for inspection shall be made 24 hours in advance- phone 259-8810. � <br /> 2. All work shail be pertormed in accordance with this permit and current City of Everett Design and O <br /> Construction Standards and Specifications. <br /> 3. Call Location Unr�rground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-e24-5555. <br /> ♦�^ <br /> V♦ <br /> - . O <br /> a <br /> •uYuc woRKs �kRWr <br /> P:OT�,R,�EOUIREA <br /> S Y__p_� �� <br /> �AT T <br /> � KNOWLEDGEMENT OF�O;JC,?mnn;g <br /> The undersigned owner/applicant hereby agrees to hold and save harmless <br /> the City of Everett from any and all claims tor damages,costs,expenses,or <br /> Approvetl for Construction Date causes ol action that may arise because ot installation and maintenance of <br /> the improvement or other right•of-way use hereto applied for and turther agrees <br /> to remove same upon noticu from the City and to repiaee public property <br /> damagedthereby. <br /> P�NA�INSPECTION Date <br /> Approved as Constructed <br /> Sfgnature of Applicant Oate <br /> '�VORK qUTHORIZED BY THIS PERMIT MJST BE STP.RTED WITHIN 180 DAYS OF DATE pERMIT IS ISSUED AND THERFI�FTER IS TO BE DILIGENTLY PURSUED TO <br /> COMPlET10N.THIS PERMIT MAY BE CANCEILED BY THE CIN UPON ANY STOPPqGE OF WORK ON THIS PROJECT OVER 90 DAYS DURqTION. <br />