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NR 21 1991, <br />POSTINHE *R 1 , .r . <br />Date_1aL5�3 PUUbc Works Permit • G <br />Application For Bldg Dept . 39268rq 'Z ` <br />PUBLIC WORKS PERMIT PebTotelFeeFae s — <br />Print or Type Only <br />Leg, epol Fee Psid 5 _ <br />Selene Dee S zO p0 <br />Jim S Bonnie 905 85th St SE Everett WA 98208 353-5115 <br />Mailing Address City Zip Phnne <br />Goode Conat 11217 60th St NE Lk Stevens 98258 334-9262 <br />Applicant Mailing Address cqy Zip Phone <br />Describe Proposed Work new garage <br />Proiect Address (It known) <br />SE <br />Attach four (4) copies of plans for proposed work - Draw to scale and nele thF 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 measuremejits <br />PERMIT CONDITIONS <br />1. All calls for Inspection shall be made 24 hrs. in advance - phone 259.8810. <br />2. All work shall be performed In accordance with this permit and current City of Everett Deslgn and Construction <br />Standards and Specifications. <br />�3. Ce:l Location Underground Service 49 hrs. before yru dig. TOLL FREE NUMBER 1.800-424.5555. <br />Appr d or Constrtfr.tion Date <br />le <br />`FINAL INSPECTIO Data <br />Apprcved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Ceder Street <br />Everett, WA 98201 <br />Phone: 259.8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />ra <br />O <br />a <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 pro rty damaged thereby. <br />Signature of Applicant Date <br />WORK AUTHORIZE(] 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. THIS PERMII MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />