4734 GLENWOOD AVE 2016-01-01 MF Import

� :^f�PPlication For _. PUBLIC .JORKS PERMIT o� 9/19!y6 PUBLIC WORKS DEPARTMENT Public Works Permit N 3200 Cedar Street Everr.tt.WA 98201 259-8810 BulldingPermitM 52Q7q TYPE OR PRINT ONLY Public Works Fee$ CHARLES ADAMS 4734 GLENWOOL EVERETT 98203 Owner Mailing Address City Zip Phone STEVE MORRIS 691-4212 Applicant Mailing Address City Zip Phone Describe Proposed Work CO*ISTRUCT GARAGE/CARPORT � � � �// PROJECT ADDRESS(if known) 4734 GLEN4100D Atlach four(4)copies ot plans for proposed work-Draw to scale and note the tollowing if applicabie: � � •Property Llnes "Outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utllities O •Centerline of streot •Indica:e North •Show any proposed grading changes •Show measurements � DO NOT WRITE BELOW THIS LINE PERMIT CON�ITIONS: � �, p.11 calls for inspection shall be made 24 hours in advance- phone 259-8810. O I 2. Aii work shall be performed in accordance with this permit and current City of Everett Design and !' Construction Standards and Specifications. ! 3. Call Lccation Undergro�nd Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. H V♦ :'tIRLIC WORKS ��PAIn O KO� 9EUUIl16! � i 'y � >ATF..---y-�-5 _96 _} I ACKNOWLEDGEMENT OF CONDIl10NS The undersigned ownedapplicant hereby agrees to hold and save hanniess tho City of Everett from any and all claims for damages,costs,ezpenses,or Approved for Construction Date causes of action that may anse because of tnstallntlon and maintenance of the improvement or other righ4of-way uso hereto applied tor and furthar agrees to remove same upon notice from the City and to replace public properry damaged thereby. FINAL INSPECTION Date Approved as Constructed Signature of Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST B'e STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND TNEREAFTER IS TO BE DILIGEN7LY PURSUED TO COMPLEf10N.THIS PERMIT MAY BE CANCELLED BY THE CIlY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURA770N.