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N'� <br />Date <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />�� <br />Owner <br />Appl�— <br />Describe Proposed Wc <br />Plan Check No: B 38170 SEPA <br />Applicat.Date: 09/25 92 <br />Job Ad�ner: MILLERISTANIA AVE <br />Tenant: <br />Propoeed Use: GARAGE/STORAGE <br />Deec. of Work: <br />GAAAGE W/STORAGE ON UPPER LEVEL <br />OFFICE SET JOH SET� <br />APPROVED FOR PERMIT: DATE_/_I_ BY <br />� IPuoM1c Worwa Parm�t • <br />emo. oeo�� • — <br />Zip <br />P�EiicWo�ifee S <br />To�ei Fee <br />Less Appl Fee PeiE S <br />Bai�nce0ue S <br />Prolect Address (if known) <br />Altach lour (4) copies of plans for proposed work • Draw to scale and note� Ceniterline ot ��eeii able: <br />• Property Lines • Indicate North <br />• Outline and dimensions ot all existing and � Show any proposed grading changes <br />proposed structures on Ihe lot � Show measurements <br />• Existing and proposed ulilities <br />Phene <br />PERMIT CONDITIONS <br />1. All calis for Inspeclion shall be mede 24 hrs. in advance • phone 259•8810. <br />2. All work shell be pertormed In accordance with this permit and cunent City of Everett Design and Construction <br />Standards e�d Speclfications. <br />3. Call Locetlon Underground Servicu 48 hrs. before you dig. TOLL FREE NUMBER 1-800�424•55 . <br />S�flP-.S�u.�� �„�.,,fr,o�.uJ>�.�„�� -r,<.,�z` 6c. /tv�a-,.�� <br />( �,ccu,ca, ��. ,t¢�✓e�. �l�fu�io��'2r,<f) at� 7na�n�:.i� U <br />� � <br />�DtpL, -�io,.C� -��•c� C/z,��c,Lr„ /�i�c��..�-,•� Cva�e� /Lcr�c-ccn�r�' <br />�i���«.i�.� P�,x6�..� �e2,n�� <br />tio ���� �ti�� ��' ��u=�, <br />y�—� �v-�-P�� <br />Approved for Construction Dale <br />FINAL INSPECTION Date <br />Approved as Consiructed <br />�AIQ�� PUBLIC WORKS DEPARTMENT <br />3200 Cedar Slreet <br />Everett, WA 98201 <br />Phone: 259-8810 <br />� <br />� <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hareby agrees to hold and save harm- <br />less the City ol Everett irom any and all claims for dameges, costs, <br />expenses, or causes of action that may arise because of installation <br />and maintenance ol lhe improvement or o'her rig�l-obway use hereto <br />applied tor and lurther agrees to remove same upon notice irom the <br />City and to replace Pu61ic property damaged �h ±reby. <br />Signature ol Applicanl Date <br />BORD YSTOFORDATE PERMIT iSESSUED AND NEREAFTER ISHTO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANV STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />