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Date <br />Applicalion For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Owner <br />APPlicanl <br />Describe Proposed Work <br />Project Address (it known; <br />Plan Check No: B 45850 <br />Applicat.Date: 10/14/94 <br />Job Addreas: 206 W MARILYN <br />Owner: BRUNSON AOSE M <br />SEPA <br />Tenant: <br />Proposed Uee: SINGLE FAMILY RESIDENCE <br />Desc. of Work: <br />GARAGE ADDITION <br />OFFICE SET JOB SET <br />APPROVED FOR PERMIT: DATE_/_/_ HY <br />'upl¢ Worha Peimll • <br />IOI�V. OcOi. + - <br />Pu�Lc Worka Fe0 <br />T0101 F!! 5 <br />Lesf Aool Fee PaiC S <br />Babnce0ue 5 <br />4ttach four (4) copies ol plans lor proposeJ �rurk � Dral:� lo scaL± and ncte iha :oiluwing as apU�ir.able: <br />• Property Lines <br />• Outline and dimensions ol a11 existing and <br />proposetl structures on the lot <br />• Existing and proposed utililies <br />• Cenlerline ot street <br />• Indicate North <br />• Show any r,roaosed grading changr.s <br />• Show measurements <br />Phone <br />Phone <br />PERMIT CONDITIONS <br />1. All calls lor Inspection shall be made 24 hrs. in advance • phone 259•8810. <br />2. AII work shall be perlormed in accordance with ihis permit and current City of Everett Design and Construction <br />Standards and Specilications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424•5555. <br />'UBLIC WORKS PEPMIT <br />K07 REOUIREII <br />ay <br />•:ATE o /� 9 S� <br />�roved lor Cor,struction Dale <br />!Al INSPECTION <br />�roved as Conslructed <br />PUBLIC WORKS DE(•,1RTMENT <br />3200 Cedar Street <br />Evered, WA 9820t <br />Phnne:259•8870 <br />Dale <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />_ / <br />` <br />� <br />� <br />v / <br />O <br />a <br />The undersiqned owner/applicznt herr.by agrees to hotd and save harm• <br />less Iha City ol Eve�ett Irom any antl all claims lor damaqes. costs. <br />ezpenses. or �auses ol action Ihat may aris^ because ol installation <br />and m�intenance ol the improvement or other righl•ol•way use hereto <br />appi�?�: lor and lurther agrees Io remove same upon nolice Irom the <br />C�;y and to repiace public property damaged Ihereby. <br />Signalure ol Applicant Date <br />WORK AUTHORI2ED BY THiS PERMIT MUST BE STARTED WITNIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT tdAY BE <br />CANCELLE� BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />