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� <br /> , ( ?Dlicytion For ,� <br /> � PUBLIC WORKS PERMIT �a�e 11-24-98 <br /> PUBLIC WORKS DEPARTMENT Public Works Pertnit ft <br /> 3200 Cedar Street <br /> Everett,WA 98201 259-8810 Buildin,;Permit N 60937 <br /> Tl'PE OR PRINT ONLY Public Warks Fee$ <br /> John 5 Deborah LaPeer 228 Dorn Ave (A) Everett WA 98208 425-513-2797 <br /> Owner Mailing Address City Zip Phone <br /> Owner <br /> Applicant Mailing Address City 2ip Phone <br /> Descrihe Proposed Work new detached Qarage <br /> W <br /> � <br /> - <br /> PROJECTADDRESS(ifknown) 6924 Jefferson Ave � <br /> Attach four(4)copies of plans lor proposed work-Draw to scale and note the following if applicable: � <br /> •?roperty Lines •Outline and dimensions o(all existing and pmposed stmcWres on the lot •Ezisting and proposed utilities O <br /> •Centedine of street •Indicate Norih •Show any p�oposed grading changes •Show measurements <br /> DO NO'f WRITE BEl_OW THIS LINE � <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspection shall be made 24 hours in advance- phone 259-8810. <br /> 2. Ail work shall be performed in accordance with this permit and current City of Everett Design and O <br /> Construction Standards and Specifications. 1 <br /> I <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � , <br /> 'UL`UC i•JOF?KS P�W � <br /> :�__��� EGUIRF:� ���� O <br /> - a <br /> �AT�"_"_ . l � <br /> ���_�� <br /> �'�a�� <br /> ACKNUWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save hartnless <br /> lhe Ciry of Everett Irom any and all claims tor damages,cosls,expenses,or <br /> Approved(or Construc�wn Date — causes of action that may arise because of installation and maintenance o} <br /> the improvement or olher ngh�-of-way use hereto applied lor and(unher agrees <br /> to remove same upon notice from the City and to replace public propeAy <br /> damaged thereby. <br /> - FINAL INSPECTION Date <br /> Approved as Constructed <br /> Signature of Applicant Date <br /> WORK AUTHORIZEO BY THIS PERMIT MUST BE 57hRTED WITHIN 100 DAYS OF DATE PERMIT IS ISSUED AND THEREP,FfER IS TO BE DILIGENRY PURSUED TO <br /> COMPLEfION.THIS PERId1T NAY BE CANCELLED BY 7HE CI7Y UPON ANY STOPPAGE Of WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />