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�� Application For <br /> PUBLIC� �I/ORKS PERMIT �'Uate <br /> � PUBLJC WORKS DEPARTMENT Publtc Works Pertnit# <br /> 3200 Cedar Street <br /> Everett,WA 98201 259-8810 Building Permit# <br /> TYPE OR PRINT ONLY Public Works Fee$ <br /> Plan Check No: B 61485 SEPA <br /> Applicat.Date: 01/28/99 phone <br /> Owner Job Address: 1S32 LOMBARD AVE <br /> Uwner: MCCOY PAT/LOUISE <br /> Tenant: <br /> Yroposed Use: GAAAGE <br /> Applicanl Desc. of Hork: Phone <br /> DETACHED GARAGE <br /> Describe Proposed Work OFFICE ssx Jos ssx W <br /> APPROVED FOR PERMIT: DATE�/__/_ BY L <br /> r <br /> � <br /> � <br /> PROJECT ADDRESS Qf known) � <br /> Attach four(4)copies of plans for proposed work-Drew to scale and note the following if applicable: � O <br /> •Property llnes 'Outline and dimensions of all ex(sting and proposed structures on the Iot •�cisting and proposed uUllties <br /> •Centerline of street •Indicate NoAh •Show any proposed greding changes •Show measurements � <br /> DO NOT WRITE BELOW THIS LIN12 <br /> PERMIT CONDITIONS: Z <br /> 1.All calls for inspection shall be made 24 hours in advarce-phone�59-9810. � O <br /> 2. All work shall be performed in accordance with this permit and cun ent City of Everett Design and <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL f"REE NUMBER.1-800-4245555. H <br /> • �(�G' ' cJ�9� �icjG'��' -� �'►Qa� (��G r,✓h�'�e � <br /> vvlc� �.��r�y,¢ - cenr�f da�hS�h 0 <br /> G. <br /> � s;d� �e�r: <br /> 'UDLIC �VOFlf(S P�RMI"� <br /> (i0? EO�IIRE!! <br /> �Y�_� . <br /> �A7E.._�__2�L�_ <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> � The undersigned ownedappl(cant hereby agrees to hoid and save harmless <br /> the Cily of Evere't from any and all claims for damages,costs,expenses,or <br /> causes of action tliat may arise because of installation and maintanance ct <br /> Approved for Construction Date the Impinvementar other right-af-way use hereto applied for and further agrees <br /> ' to remove�same upon notice from the City end to replace public property <br /> damaged lhereb��. <br /> FINAL INSPECTION Date <br /> Approved as Constructed <br /> Signature of Appiicant . Date <br /> WOFK AUTHORIZED BY hl1S PERMIT MUST BE STARTED WITHIN�IBO DAYS OF DATE PERMIT IS ISSUED AND hIEREAFfER IS TO BE DILIGENTLY PUFSUEO TO <br /> COIAPLET10N.7HIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PR0.)ECT QVER 90 DAYS DURATION. <br />