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Date 3/5/91 <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />PuhLCK'orASPeim�.�• �j—��� <br />eiaq oea�. • 91/26573 <br />Fubl¢Wo�kSFoe 5 <br />Total Feo <br />Less RpO�� Fee PaC 5 <br />BdIdnCC DUf CJ �� <br />.Pcc��d '/i3 <br />Hilt�r s rorott,v aetnrcnn dSfl� c�,-,� a.,A �,A,-Prt 5an� aao-5sa8 <br />Owner Mailing Address City Zip Phone <br />Goode Const. inc, dba NW Garaaes 11217 — 60th St NE Lk Stevens 98258 339-9262 <br />ApplieaM Mailing Address Ciiy Zip Phone <br />Describe Proposed Work �nstsuCt neW garage at SFR <br />Proiect Addres° (il known) <br />Attach four 14) copies of plans for proposed work - Draw to scae and note the lollowin� as applicable: <br />• Property Lines <br />• Outline and dimensions ol all existing and <br />proposed structures on thc lol <br />• Ezisling and pioposed utilities <br />• Centcrline of street <br />• indicate Noith <br />• Show any propo5ed grading changes <br />• Show measuremenls <br />PERMIT CONDITIONS <br />1. All calls for inspec�ion shall be made 24 hrs in advance • phone 2S9•$810. <br />2. All work shall be pertormed in accordance with this permit and current City ol Everetl Design and Conslructlon <br />Standards and Specific�tions. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•$00•424•5555. <br />y. �X,r�,;�� �r,;,�w.�y d��s hotT �����,. �o �,�c �,� <br />ttri{� �rn�oSec�' y^qi'aJe,- J�57'z lL /�ecJ �/'ivc��un�/ <br />�'U/'p Cu7` 4-s /^e�+ui/'c��e�r Ciiy Sfar�o�nrd �307 <br />�a�y 4%%aCiicc+�� /'C�(Jc:Sf rri[��in9 /�Jif� �OUGLiG k/!�/'�t <br />J ✓ / \ <br />/�SPGc7o/^ �Zfoi^e� �odn♦ !/i^��'r.'r,.�a✓GJO�� CCc�rG�c,ffac�e�l <br />J / <br />-_`,?���a-a-�' 3 i� -9 / <br />Approved for Conslruction Datc <br />FINAL INSPECTION <br />Approved as Conslructed <br />evemtt PUBLIC WORKS DEPARTMENT <br />� 3200 Cedar Sireet <br />Everett, WA 98201 <br />Phone: 259�8810 <br />NCKNOWLEDG[�dENT OF GONDITIONS <br />W <br />H <br />N <br />� <br />0 <br />� <br />� <br />� <br />a <br />The undersigned owneVappllcan� horeby agrceslo hold and save harm- <br />less the City of Eveietl Irom any and all claims for damagcs. cost;. <br />ezpenses, or causes of actien that may arise because ol installation <br />and rnaintenance ol Ihe improvement or other righl-of�way use he��lo <br />applied for and lurther agrees to remove same upon notice Irom ihe <br />Ciry and to mplace public properly damac�ed ihereby. <br />Dale — <br />Signatwe ol Applicanl Date <br />WORK AUTHGRIZED BY THIS PERMIT MUST �E STARTED WITHIN <br />180 DAYS OF DATE PFRMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGflNTLY PURSUED TO COMPLETION. THIS PERMIT tdAV BE <br />CANCELL[D BY THE CITY UFOH �NY STOPPAGE OF WORK ON TI115 <br />PROJECT OV[R 90 DAYS DURATION. <br />