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/ <br />�-i Zu-� `i -s • �- <br />Uate_- -_ <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only Plan check No: s 48585 SEPA <br />Applicat.Date: 06/12/95 <br />Job Adcire: 2021 ET7�'fE ST <br />Owner: WEST f'.UL/LINDA <br />Tenant: <br />Prop��sed Uee: GARAGE <br />Owner Deec. of Work: <br />NEW DETACHED GARAGE <br />Applicant <br />Describe Proposed Work _ <br />Project Address (ii known) <br />PuO��c Wo�ka Pe�mi1 • <br />HICp. DeO�- � _ <br />Pubbc Works Fee <br />To�al Fee s <br />Less AOD� Fee PaIO S <br />Balance O�e S <br />:ip Phone <br />OFFICE SET JOB SET <br />ip Phone <br />APPRVD FOR PERMIT: DATE_/_/_ BY <br />Altach four (4) copies of plans lor proposed work - Oraw fo scak 3nd note �he Idlowing as applicable: <br />• Property Lines <br />• Outline and dimensions o1 all existing antl <br />proposed siructures on ihe lot <br />• Exis�ing and pr000sed utilities <br />• Cen�erline ol street <br />• Indicale Norih <br />• Show any proposed greding changes <br />• Show measuremenis <br />PERMIT CONDITIONS <br />1. All cells for inspection shall be made 24 hrs. in advance • phone 259•8810. <br />2. All woi k shall be peAormed in accordance w,.h this permit and curcent City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-$00•424•5555. <br />rUBLIC WORK!3 PERMIT <br />tv0'i .P�UUIRED <br />DY <br />OATE � 9S <br />Approved for Consiruction Date <br />FINAL INSPECTION Datc <br />Approved as Construcled <br />PUBLIC WORKS DEPARTMENT <br />3200 Cetlar Sireet <br />Evere1L WA 98207 <br />Phone: 259�8870 <br />ACKNOWLEDGEMENT OF CONDI?InNS <br />W <br />H <br />� <br />� <br />O <br />� <br />N <br />O <br />a <br />The undersigned owner/applicant hereby agrees �o hold and save harm� <br />less �he City ol Everet� Irom any and all claims for damages, cosis, <br />��xpenses, or causes oi action Ihat may arise because of installation <br />a�d maintenance of the improvement or other righl-ol-way use hereto <br />applied for and further agrees to remove same upon notice from ihe <br />Ciry and to replace public property dama9ed Ihereby. <br />Signa'ure ol Applicant Date <br />WORK AUTHORIZED BY THIS PCRMIT MUST BE STARTED WITHIN <br />180 DhYS OF DATE PERMIT IS ISSUED AND THEFEAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />