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Date <br />Appllcatlon For <br />PUBLIC WORKS PERMIT <br />Print or Type O��Y <br />Owner <br />Plan Check No: <br />Applicat.Date: <br />Job Addreee: <br />Owner: <br />Tenant= <br />Propoeed Uee: <br />Deec. of Work: <br />NEW GARAGE <br />B 41139 <br />O6/29/93 <br />114 1YSTH ST SE <br />PACGETT WALTER <br />SFR/GARAGE <br />SEPA <br />APPllcenl <br />OFFICE SET JOH 6ET <br />Deecrihe Pioposed Work _ pppROVED FOR PERMIT� DATE_/_/� BY <br />Prolact Addreee (II known) <br />Puellc won. P.rmn . <br />eiaa. n.oi • .— <br />Pu!'k Wor1u FN a <br />Toul fn <br />Uu ADD� ��� p�ld � <br />B�I�ne1 Du� S _ <br />:ip PhOne <br />:Ip Phone <br />Attuch four (4) copiee ol plann lo� proposed work • Draw to ecele and note the lollowlnp es epplicable: <br />• P�ope�ty Llnee • Cenlerline ol streel <br />• Oulline and dimenelone of all exinllnp and • Indlcete North <br />proposed etructures on the lol • • Show eny proposed preding chenpee <br />• Exlsting end proposed utllitlee � Show meesurements <br />PERMIT CONDITIONS <br />1. All calle lor Inepectbn ehall be made 24 hro. in edvence • phane 259•8810. <br />2. All work ahall be performed in eccordence wlth thls permit and curtenl C�ry of Everetl Deelpn and Conetrudlon <br />Slandarde and Speclllcetlone. <br />3. Call Locatlon Underpr�und 3ervice 4B hrn. before you dip. TOLL FREE NUMBER 1-800-4245555. <br />' UBLIC WpAKS PERMIT <br />NOT pEOUIRED <br />�3 V ' i%✓,� <br />DATE � =� �� � — <br />Approved lor �onslruction Delr_ <br />FINAI INSPECTION Date <br />Approved es Conetrucled <br />�PUBLICWORKSUEPARTMENT <br />3200 Ceder Slreal <br />Everet4 WA BB201 <br />Phone: 269•8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />H <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />The underalgned owner/epplicenl heraby agreee to hold and eeve harm• <br />less ihe City of Everell Irom eny end all clalme lor dameBea, cost& <br />eapenses, o� ceuaeo ol aclion Ihat may arlee becausa ol Inalallatlon <br />end mainlenence ol lhe Improvement or olher riqht�ol•wey uee hereto <br />epplled lo� end further egreee to remove sama u0on notice Irom tha <br />Cily end to �eplece Dubllc property demaped Ihereby. <br />ulgneture ol Applicent """ <br />WORK AUTHORI2ED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PEFMIT IS ISSUED AND THEREAFTER IS �TO <br />BE DILIGENTLY PURSUED TO COMPLETION.'HIS PERMIT MAY BE <br />CANCELLED 8Y THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 80 DAYS DURATION. <br />