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Date <br />Applicallon For <br />�UBLIC WORKS PIERIVIiT <br />Print or Type Only <br />Owner <br />Applicant <br />Describe Proposed Work <br />Project Address (ii known) <br />Plan Check No: B 46788 SEPA <br />Applicat.Date: O1/23/95 <br />Job Addrs: 6320 W MAGNOLIA AVE <br />Owner: MATTOX RICHARD <br />Tenant: <br />Propoaed Use: GARAGE <br />Deec. of Work: <br />NEW DETACHED GARAGE <br />OFFICE SET JOB SET <br />APPRVD FOR PERMIT: DATE_/_/_ <br />Puolic WpIXs Permp • <br />ema o.oi � _ <br />puelic Workn Faa <br />Tolal Faa S <br />Leu ApD� Fea P�IE S <br />B�I�nw Ow S <br />Attach tour (4) copies of plans for proposed work - Draw to scaie and note the following as applicable: <br />• Property Lines • Centerline of streel <br />• Outline and dimensions of all existing and • Indicate Norih <br />proposed structures on the lot • Show any propoaed graCing changes <br />• Existing and proposed utilities • Show measurements <br />Phone <br />Phone <br />PERMIT CONDITIONS <br />1. All calis tor inspectlon shall be made 24 hrs. in advance - phone 259•881 O. <br />2. �II work sball be pedormad tn accordance with this permit and wrrent City of Everett Design and Construction <br />Standards and Specificetlons <br />3. Call Location Underground Service 48 hra before you dig. 70LL FREE NUMBER 1•800�424•5555. <br />Approved for Construction <br />r'UBLIC WORK5 PEPSMIT <br />NOT REOUIRE� <br />9Y 9�B <br />r,qTE.�� <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />H <br />� <br />The undersigned owner/applicant hereby agrees to hold and save harm• <br />Iess the Ciry ol Eveiett Irom any and all claims tor damagea costs, <br />expenses, or causes of action that may arise because of installation <br />and maintenance of Ihe improvement or other right•of-way use hereto <br />app!ied for and further agrees to remove same upon notice frcm the <br />Date City and to replace public property damaged thereby. <br />FINAL INSPECTION Date <br />Approved as Conslructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everel4 H'A 98201 <br />Phone: 259-8870 <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST DE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTEti IS �TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PRO,IECT OVER 90 DAYS DURATION. <br />