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6 <br /> . <br /> i ; <br /> Date `3�� S�y ''"` �"` h0lic WOA�Perma• � <br /> . BIU9.DaDt• ��_3 �� <br /> Application For <br /> PUBLIC WORKS PERMIT PueTotelFeeFee S i <br /> Lea�pG�Fee PAE S <br /> B�i�nceDue s �� <br /> ��� Print or Type Only <br /> p�� Plan Check No: B 36135 SEPA ; <br /> Applicat.Date: 03/26/92 <br /> 9 y N Job Addreae: 5825 GLENWOOD AVE � <br /> Owner Owner: HIDDENDORF, RICHARD Zip Phone <br /> H �� Tenant: <br /> y H Proposed Use: CARAGE <br /> �C C� Desc. of Work: � <br /> y� GARAGE 484 SF Phone �t <br /> � H� APPlicant 2ip ,. <br /> � �H �: <br /> Z OFFICE SET JOB SET �� <br /> � y� Describe Proposed Work . APPROVED FOR PERMIT: DATE_/_/_ BY +� . <br /> OH <br /> H �8 - <br /> �" � W <br /> zy� <br /> � H y Project Address(if known) � <br /> N � <br /> H Attach lour(A)copies ot plans for proposed work-Draw lo scale and nete the following as applica6le: <br /> Qn Cd y • Property Lines • Cenlerline ot street ,^ <br /> 3 [s]� • Outline and dimensions of all existing and • Indicate North V� I <br /> a • Show an ro os g g <br /> proposetl structures on the lot y P P ed gradin chan es � <br /> yp y • Existing and proposed uNlities • Show measurements M ' <br /> W <br /> DO NOT WRITE BELOW THIS LINE w <br /> PERMIT CON�ITIONS �� <br /> 1.All calls lor Insbection shall be made 24 hrs.in advance•phone 259•8810. � <br /> -� 2.All work shall be performed in accordance with this permit and current Cily ot Everett Design and Construction <br /> Standards and Specilications. <br /> '.�� 3.Call Location Undergrou�d Service 48 hrs.belore you dig.TOLL FREE NUMBER 1•800•424•5555. ' . � <br /> .�..� <br /> '�w /��L'���.0 Cc�.�Zf%.i/li '7)�"��"�`q( �.y,:i�/1 :( �� . <br /> � � /,��� � <br /> i� <br /> �:i % � _I <br /> �� T - <br /> 1 ' <br /> A� O <br /> _s � <br /> s <br /> !� � ACKNOWLEDGEMENTOFCONDITIONS <br /> The undersigned owner/applicant hereby agrees to holtl and save harm� <br /> less the City of Everett trom any and al� claims for damages costs, <br /> � expenses, or causes of action that may arise because of installation <br /> �t' and mainlenance ot the improvement or ot�er right•of�way use hereto <br /> applied lor and further agrees to remove same upon notice Irom the <br /> Approved tor Construction �ate City and lo replace public property damaged Ihereby. <br /> y��� <br /> FINAL INSPECTION Date �a;e <br /> Approved as Consiructed Signalure ol ApplicaN <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED�WITHIN <br /> PUBLICWORKSDEPARTMENT 180 DAYS OF DATE P�RMIT 13 ISSUED AND THEREAFTER IS TO <br /> �200CedarStreet BE OILIGENTLY ^'J^oUED TO COMPLETION.THIS PERMIT MAY BE <br /> Evarett WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259�8010 PROJECT OVER 90 DAVS OUFATION. <br />