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� <br />� <br />TYPE OR PRINT ONLY <br />Owner <br />Applicant <br />,plication For <br />PUBLIC WORK:S PERMIT <br />Describe Proposed Work _ <br />PROJECT ADDRESS (if known) <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Stra�t <br />Everetl, WA 98201 259-8810 <br />Data <br />Public Works Permit N <br />Building Pennit N _ <br />'�rks Fee $ _ <br />Plan Check No: H 5242? SEPA <br />Applicat.Date: 07 29/95 <br />Job Addreee: 24 6 1'AYLOR DR <br />Owners SOTO HEC;OR/DEBRA <br />Tenant: <br />Propoeed Uee: SINGLE FALIILY RESIDENCE <br />Deec. of Work: <br />REMODEL OF GARAGE TO LIVINC SPACE. NEW <br />CARACE <br />OFFICE SET JOB SET <br />APPROVED FOR PERMIT: DATE_/_/_ BY � <br />Phone <br />Phone <br />Atlaeh four (4) copies of plans for proposad work - Draw to scale and note the following if applicable: <br />7ropeAv L1nes `Outline and dimnnsions of all existing and proposed structures on ihe lot •Existing ond pr�posed utilities <br />'Ce�iteAina of street •Indiwte NoAh 5how any proposed greding changes 'Show measurements <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance - phono 259-8810. <br />2. All work shall be performed in accordance with this permit and r,urcent City of Everett Design and <br />Construction Standards and Speciflcations. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />�Uo I'ubl,7 bt�ar�Es �.�,,; f �� „�'� <br />Approvetl for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />�/�'�y� — <br />� <br />O <br />♦�^ <br />v♦ <br />0 <br />a <br />ACKNOWLEDGEMENT QF CONDITIONS <br />The untlersigned owner/applicant hereby agrees to hold and save hartnless <br />the City o1 Everett from any and all claims for damages, costs, ezpenses, or <br />causes of action that may arise 6ecause of installation and maintenance of <br />the imp�ovement or other right•ot•way use herefo applied for and further agmes <br />to remove same upon notice ffom tha City and to replace public pmperty <br />damaged thereby. <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEHEAFfER IS TO BE DILIGENTLY PURSUEO TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BV THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />