1721 63RD ST SE 2018-01-02 MF Import

Date_ _ Application For PUBLIC WORKS PERMIT Print or Type Only Applicant Describe Proposed Work Project Address (it known) Plan Clteck No: B 41057 Applicat.Date: 06/23/93 _ Job AddreBB: 1721 63RD ST NC Owner: BRANDVOLD DUANE Tenant: Proposed Use: GARAGE Desc. of Work: DEMOLISH PART OF AND MOVE PART GARAGE — CONSTRUCT 10 X 27 OFFICE SET JOB SET Public Works Permit a Bid, Dept. a Public. Works Fee Total Fee S Less Appt Fee Paid S Balance 0.0 f SEPA OF EXISTING APPROVED FOR PERMITt DATE_/_/_ BY Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: • Property Lines • Centerline of street • Outline and dimensions of all existing and • Indicate North proposed structures on the lot • Show any proposed grading changes • Existing and proposed utilities • Show measurements DO NOT WRITE BELOW THIS LINE Phone PERMIT CONDITIONS 1. All calla for inspection shall be made 24 hrs. In advance - phone 259.8810. 2. All work shall be performed In accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hre before you dig. TOLL FREE NUMBER 1.800-424.5555. PUBLIC WORKS PERMIT NOT REOUIRED By_j DATE ,' y ' Approved for Construction Date FINAL INSPECTION Dale Approved as Constructed WORKS DEPARTMENT" 6LPUBLIC 3200 Cedar Street Everett, WA 9F 201 Phone: 259-8810 ACKNOWLEDGEMENT OF CONDITIONS W z O The undersigned owner/applicant hereby agrees to hold and save harm- less the City of Everett from any and all claims for damages, costs, expenses. or causes of action that may arise because of Installation and maintenance of the Improvement or other right-of-way use hereto applied for and further agrees to remove same upon notice from the City and to replace public property damaged thereby. Signature of Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION, THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.