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Dale <br />Ap�lication For <br />PUBLIC WOR�.S PERMIT <br />Print or Type Only <br />Plan Check No: B 44745 <br />Applicat.Date: 06/23/94 <br />Job Addre: 3722 HOYT AVE <br />—�— Owner: GO�TT GREG <br />OwnP.i <br />Tenant: <br />Proposed Use: GARAGE <br />Lesc. of Work: <br />- NEW GARAGE <br />Aoo�ica�t <br />Describe Proposed Work <br />Project Adtlress U� knuwnl <br />Putl��f. Ylorks Pe�m�l + . <br />5ieq Deoi. • — <br />vu�bcww�sFee 5 <br />toiri cee <br />Less>Ool Fee Pa�C S <br />Bala�re Oue 5 <br />SEPA <br />OFFICE SET JOB SET <br />APPRVD FOR PER2IIT: DATE_/_/_ BY <br />Aitath four (41 COPies o� Plans lui UroP��z� 19'�'" ' D�av: b.cai.• .c+r. ncie.'C� n'terf�ne af st eetab�e: <br />• PrOPeriy LineS • InCic3l•' Narih <br />• OuUme and dimensions of a11 existing antl �:new any r,reaosed gratliny chanaes <br />proposed struc�ures on �hr. �oi � Stio��' rtiraSUr�menl5 <br />• Exis�ir�g and propOsed utilities <br />DO NOT WPITE dELO i.INE <br />Phnn� <br />Phone <br />PERMIT CGNDITIONS <br />1. All calls for inspeclion shall be made 24 hrs. in advance - phone 259•8810. <br />2. All work shall be performed in accord2nce with this permit and wcent City of Everett Design and Construction <br />Sfandards and Specifications. <br />3. Call Localion Underground Service 48 hrs. be(ore you dig. TOLL FREE NUMBER 1-800-�124-5555. <br />.�✓ <br />��5e� <br />S� Jr <br />�� ��,� ��,� <br />I� ' � <br />� <br />�,NIilA6 ��SP��71oh <br />KIRK BR00�CS <br />� ,�� ��.-- <br />�AtE ----'` <br />Approved lor Construction <br />Date <br />FINAL INSPECTION � Dale <br />Approved as Constructed <br />PUBLIC WOHKS DEPARTMENT <br />3200 Cedar Street <br />fY R Eveiell.VJA�JG201 <br />Z <br />O <br />�"' <br />� <br />O <br />a <br />ACKNOWLEDCiEMENT OF CONDITIONS <br />The �.indersianed avner/appi�can� ne�eby agrees to hold antl sa:e harm- <br />—i less ;ha Cdy o� cverell Irom any and ali c;aims lor damaqes. Gosls <br />; gxpenses. or causes o� aclion that may aris? be[ause o� ins�ailation <br />-��- and :n, iote�anr,e o! tnC improvement or other rigni-ol�way use he�e�o <br />app��.ei, 10� and �urther agrees lo r¢move Same upon nolice ��om Ihe <br />IG�;y ard lo replace public propeny damaged thereby. <br />Date <br />Signature o! :.vp��canl <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED Wll-HIN <br />180 DA'!S UF DATE PERMIT IS ISSUED AND THEREAFTER IS 70 <br />BE OILIGENTLY PURSUED TO COM1�P�ETION. THIS PC-RMIT MAY BE <br />CAF1Cc� L ED P'! TI'.E CiTY UPON ANY STOPPAGE OF WORK ON THIS <br />�,_,,. ,_,r ,.,,.....n nnvc ni ionYUW <br />[] <br />