208 78TH PL SW 2016-01-01 MF Import

Date—_— APplCdh On F'or e�p.W. PUBLIC WORKS PERMIT TMv { Print or Type Only Plan Check Not B 39742 SEPA Apel Scet.Oetet 03/03/93 _ Owner - � Add roe:: 209 79TH PL SW Zip Phone Owner: BROCKWAY JAN Tenant: Proposed Uset GARAGE Desc. of Work. APphwnl NSW GARAGE 720 SF Z.p Phone Describe Proposed N OFFICE SET_ JOB SET APPROVED FOR PERHIT: DATE_/_/_ BY_ _1, 1 W Prefect Address til known) Attach four(4)copies of plena for proposed work-Draw to scale and note the todowlnp as amicable ae� •Property Lines •Centerline of street /n •Outline and dimensions of all endoung and •Indicate North v+ proposed structures on The lot •Show any proposed priding changes •Eliding and propwed utilities •Sho.Y measurements Y DO NOT WRITE BELOW THIS LINE O PERMIT CONDITIONS t.All wore for ll b Inspection shell in made 74 a it advance panda 259•8310. 7.All wort:shell be pedormcd In accordance with this permit and current City of Everett Design and Construction Standards and Specifications G.Cell Location Underground Service 48 him before you dig.TOLL FREE NUMBER 7.800424.5555. z O INITIAL INSPECTIGr` Iffififfir CIOKIR'K�BROOKS O OATS 3/ 7 fiesse ACKNOWLEDGEMENT OF CONDITIONS The undersigned owneOaPPlicant hereby agrees 10 hold end gave halm- test the City of Everett from any and all ctalme for damages costs. expenses. or causes of action that may arise because of Inshlletion and maintenance of Ind Improvement or other right-of-way use hereto applied for and funnier agrees 10 remove same upon notice from The Approved for Construction Dale City and to replace public property damaged thereby. FINAL INSPECTION Dale Approved as Constructed Signature of Applicant Date PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MAST BE STARTED WITHIN PUBLIC RKSM ISO DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO 32000 da B tree BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE ImomI 7808810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 00 DAYS DURATION.