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y � N <br />taE �y <br />p C <br />C N <br />H � n <br />Ot70 <br />romH <br />�.�� <br />� � h <br />t� y � <br />M H <br />N <br />O N <br />� �y N <br />H O N <br />� � � <br />Date <br />qppli[ation For <br />PUBLIC VVORKS PERMIT <br />Print or Type Onry <br />Owner <br />App�icant <br />Plan Check No: H 37681 <br />Applicat.Date: O9/11/92 <br />Job AdOwnec: COOLE��EARL <br />Tenant: <br />Peoposed U,e: GARAGE <br />Desc. oE Work: <br />4805F POLE BLDG <br />Descri6e Proposed Work pFFICE SET JOB SET__ <br />APPROVED FOR PERMIT: DATE_/_I <br />Pupec Wo�As Pormd r <br />Oiaa ocPi. • 7 /��' �' i <br />Puol¢\4orb Fee 5 <br />ToleiFee <br />leiSADP�FeBPYiC `S <br />9abnce o�e S <br />SEPA <br />Phone <br />6Y <br />Prolect Atldress (il known) <br />Allach four (4) copies ol plans lor proposed work - Dnw lo scale and no�e � Ceote line of slPeeii able: <br />• Property Lines • Intlicate Norih <br />• Outline and dimensions of all ezisting and � Show any proposed 9�ading changes <br />proposed struclures on the lot • Show measuremeNs <br />• Eais�ing and proposed utililies <br />Phone <br />PERMITCONDITIONS <br />1. All calls lor inspeclion shall be made 24 hrs. in advance - phone 259•8810. <br />2, All work shall be pedormed in eccordance wilh this permit and curtent City ol Everett Design and Construclion <br />Standards and Specitications. <br />3. Call Location Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1-800•424•5555. <br />qpproved lor Construc�ion Dale <br />FINAL INSPECTION Date <br />Approved as Conslructed <br />PUBLIC WORKS DEPAR7MENT <br />3200 Cedar Street <br />Everet4 WA 98201 <br />Phone: 259�8870 <br />,•1 <br />�i <br />N <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersignetl owner/applicaN hereby agrees �o hold and save harm- <br />less ihe City ol Evere�t Irom any and all claims br damages, costs, <br />expenses, or causes ol action Ihat may arise because of instaltation <br />and maintenance of Ihe impro�ement or other right-of�way use herelo <br />applied for and luriher agrees lo remove same upon notice Irom Ihe <br />C�ty and to repiace public pmperry damaged ihereUy. <br />Signature ol AppliCant Datc <br />80ROAYSTOFRD?TE� PERMIT ISEISSUED AND THEREAFT�ER IS TIO <br />OE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED OY THE CITY U�OPI ANV STOPPAGE OF WOR�( ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />-- _— _ __' I <br />