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� <br />.� <br />NPE OR PRINT ONLY <br />1lication For r"^ <br />PUBLIC WORKS PERMIT Date_ <br />Applicant <br />Describe Proposed Work _ <br />PROJECT ADDRESS (if known) <br />PUBLIC WORKS DEPARTMENT Public Works Permit k <br />3200 Cedar Street <br />Everett, WA 98201 258-8870 <br />Building Permit 8 <br />Public Works Fee $ <br />Plan Cher.k No: B 50472 SEPA <br />Applicat.Date: O1/04/96 <br />3ob Addteee: 24b1 56TH ST SW Phone <br />Owner: DOWE MATT <br />Tenant: <br />Proposed Uee: SINGLE FAMILY RESIDENCE <br />Deec, of Work: Phane <br />GAZEBO 14 X 14 �� <br />OFFICE SST JOB SET � <br />APPAOVED FOR PERMIT: DATE_/_/ <br />Atlach four (4) coples ot plans for proposnd work - Draw to scale and note the fol�owing if applicable: <br />'Property Lines 'Outline and dlmenslons of all existi�g and proposed structures on the lot •Existing and proposed utilities <br />'Centerline of street ■Indicate North •Show eny proposed grading changes •Show measurements <br />---- -.....----_.. ......���.� <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 7-800-424-5555. <br />�U9LIC WO KS PEpM�, <br />��oT __auiRen <br />a v_ <br />YATF, __ .-.r.• 9 . <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />ACKNOWLEDGEMEPlT OF CONDITIONS <br />The und•.rsigned owneNapplicant hereby agrees to hold antl save harmless <br />the City of Everett from any and all claims for damages, costs, expenses, or <br />causes of action that may arise because of Insta�lation and maintenance of <br />the Improvement or other right-of-way use herato applied for and further agrees <br />to mmove same upon not(ce from the CNy and to replace public property <br />damaged thereby. <br />Signature of Applicant Date <br />WORK AUTHORIZEO BY THIS P�I?i.ilT MUST BE STAqTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfF:R IS TO BE DILIGENTLY PURSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPqGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />