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Date '`' I <br />ApPlicatiun For <br />PUBLIC WORKS PERMIT <br />Print or Type Only Plan Check No: B 42708 SEPA <br />Applicat.Date: 11/15/93 <br />Job Addrs: 1520 63RD ST SE <br />Owner: MARTINEZ GEORG 6 DONNA <br />Tenant: <br />Owner Proposed Uae: GARAGE/SFR <br />Deec. of Work: <br />NEW GARAGE <br />Applicant OFFICE SET JOB SET <br />APPRVD FOR PERMIT: DATE_/_/_ BY <br />Describe Proposed Work _ _ <br />Project Address (If known) <br />PUOLC WOlkr Pelme <br />eldp Derr I � <br />PublIC Works Fee <br />Total Fee $ <br />Less A001 Fee PAd S <br />Bmoce Due S <br />Attach lour (4) copies of plans for proposed work - Draw to scale and note the following as applicable: <br />• Property Lines • Centerline of street <br />• Outline and dimensions of all existing and • Indicate North <br />proposed structures on the lot • Show any proposed grading changes <br />• Existing and proposed utilities • Show measurements <br />Phone <br />Pr:RMITCUNDITIONS <br />1. All calls for Inspection shall be made 24 hrs. In advance - phone 259.8810. <br />2. All work shall to performed In accordance with this permit and current City of Everett Design and Construction <br />Standaras and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800.424.5555. <br />Approved for Construction <br />FINAL INSPECTIO 1 <br />Approved as Constructed <br />CU7PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone: 259.8810 <br />F 'BLIC WORKS PERMIT <br />NOT EOUIRED <br />0y /7 9} <br />DATE <br />e <br />Dale <br />W <br />U) <br />Im <br />O <br />n <br />z <br />O <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City of Everett from any and all claims for damages, costs, <br />expenses. or causes of action that may arise because of installation <br />and maintenance of the improvement or other right-of-way use hereto <br />applied for and further agrees to remove same upon notice from the <br />City and to replace public property damaged thereby. <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. rHIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />