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TYPE OR PRINT ONLY <br />Application For <br />PUBLIC V110RKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Sireet <br />Everett, WA 98201 259•8810 <br />Date <br />Public Works Permit k <br />Building Permit A _ <br />Public Works Fee $ _ <br />Plan Check No: S 57241 SEPA <br />Applicat.6ate: 11/25 97 <br />Owner Job Ad�9rese: 1225 ZSON ST <br />�h+ner: HUN HOEURT <br />Tanant: <br />Propoee�i Uee: GARAGE/DECK <br />Applicant <br />Describe Proposed Work _ <br />Desc. of Work: <br />GARAGE WITH DECK ON TOP <br />OFFICE SGT JOB SET <br />APPROVED FOR PERMrT: DATE_/_/_ BY, <br />?ROJECT ADDRESS (if known) <br />Phone <br />Phone <br />�itach four (4) copies of plans for proposed work - Draw to scale and note the tollowing if applicable: <br />•Property Lines •Oulline and dimensions of all existing and proposed structures on the lot •Exisling and proposed utilities <br />•Centerline ol street •Indicate No�ih •Show any proposed grading changes •Show measuremenls <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. <br />2. All work shall be pertormed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />INITIAL �IiSfPECt10N <br />PAUL AAcKEE <br />� <br />/ �� <br />"URLIC WOftKS PFFlM�1 <br />wor,,yq��,ui�a� <br />�v.____,�''r vi <br />ar+Ts �,n— __. ���.� y <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />� <br />O <br />��/� <br />V ♦ <br />�A <br />I.i� <br />ACKNOWLEDGEMENT OF CON�ITIOMS <br />The undersigned owner/applicant hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damages, cosls, czpences, or <br />causes of action �hat may arise because ot installation and maintenance of <br />ihe improvement or other ri9ht-of-way use hereto applied for and further agrees <br />to remove same upon notice trom ihe City and to replace public property <br />damaged ihereby. <br />Signature of Applicant Date <br />tMORK AUTi10RIZED BY THIS PERMIT MUST AE STARTED WITHIN 180 DAYS OF DATE PERMR IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURSUED TO <br />�OMPLEfION. THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />