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Date Public Works Permit# <br /> • Application For Bldg.Dept * <br /> PUBLIC WORKS PERMIT Public Works Fee <br /> Total Fee $ <br /> Less AppL Fee Paid $ <br /> Print or Type Only Balance Due $ <br /> Plan Check No: B 40614 SEPA <br /> Owner Applicat.Date: 05/14/93 Phone • <br /> Job Address: 2417 VIRGINIA <br /> Owner: BOOTH GENE <br /> Tenant: <br /> Applicant Proposed Use: GARAGE Phone <br /> Desc. of Work: <br /> NEW GARAGE — 576SF <br /> Describe Proposed Work _ <br /> OFFICE SET JOB SET <br /> APPROVED FOR PERMIT: DATE / / BY <br /> w <br /> Project Address(if known) 1.111.11 <br /> Attach four(4) copies of plans for proposed work- Draw to scale and note the following as applicable: mom <br /> • Property Lines. • Centerline of street <br /> • Outline and dimensions of all existing and • Indicate North CO <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS 0 <br /> 1.All calls for inspection shall be made 24 hrs.in advance-phone 259-8810. <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design and Construction in <br /> Standards and Specifications. • <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800-424-5555. z <br /> 0 <br /> !MUM <br /> inimmos <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br /> less the City of Everett from any and all claims for damages, costs, <br /> • expenses, or causes of action that may arise because of installation <br /> and maintenance of the improvement or other right-of-way use hereto <br /> applied for and further agrees to remove same upon notice from the <br /> Approved for Construction Date City and to replace public property damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed Signature of Applicant Date <br /> PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200 Cedar Street 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259-8810 <br /> PROJECT OVER 90 DAYS DURATION. <br />