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plicalmn For <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPAR' AENT <br />3200 Cedar Street <br />Everett, WA 98201 259-8810 <br />TYPE OR PRINT ONLY <br />Owner <br />4pplicant <br />Describe Proposed Work <br />PROJECT ADDRESS (if known) <br />Date _ <br />Public Works Permit a _ <br />Building Permit It <br />Public Works Fee $ _— <br />Plan Check No: B 53274 SEPA <br />Applicat.Date: 10/18/96 <br />Job Address: <br />O3BRIENHKCT SW <br />Tenant: <br />Proposed Use: GARAGE <br />Deac. of Work: <br />NEW DETACHED GARAGE <br />OFFICE SET JOB SET�� <br />APPROVED FOR PERMIT: DATE_/_/_ BY <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following if applicable: <br />•Property Lines 'Outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities <br />-Centerline of street 'indicate North *Show any proposed grading changes •Show measurements <br />Z�] <br />LI <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />No PUbljt, A(OrK4 Permit 4a,li <br />pm - <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />W <br />co <br />O^ <br />z <br />O <br />V♦ <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damages, costs, e::penses. or <br />causes of action that may arise because of installation and maintenance of <br />the improvement or other right-ol-way use hereto applied for and further agrees <br />to remove same upon notice from the City and to replace public property <br />damaged thereby. <br />Signature of Applicant Date <br />WORK BY THIS PERMIT MUST BE STARTED <br />COMPLETION. T14 SAUTHORIZED PERMIT MAY BE CANCELLED BY THE CITYWITHIN THEREAFTER <br />UPON ANY STO PAGE OF WORK ON THIS PROJEC O ER 90 DAYS DURATION. <br />Y PURSUED TO <br />