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� ':ati0n For . .._ <br /> PUBLIC WJRKS PERMIT Date <br /> PUBLIC WORKS DEPARTMENT Public Works Pertnit k <br /> 3200 Cedar Street <br /> Everett,WA 98201 259-8810 <br /> Building pertnit p <br /> 7YPEORPRINTONLY plan Check No: B 50806 SEPA •sFee$ <br /> Applicat.Date: 02/06�96 <br /> Job Addresa: 4960 LM ST <br /> Owner: ROYAL CLIFTON <br /> p�y�ef Tenant: <br /> Proposed Use: SINGLE FAMILY RESIDENCE Phone <br /> Desc. of Work: <br /> NBW CARPORT <br /> Applicant Phone � <br /> OFFICE SET JOB SET <br /> Describe Proposed Work_ ApPRoven FOR PERMIT: DATE_/_/_ Hy � <br /> � <br /> � <br /> PROJECT AUDRESS(if known) � <br /> Ariach tour(4)copies of plans for proposed work-Oraw to scaie and note the foilowing it applicable; � <br /> •Property Lines 'Outline and dimensions of all existing and proposed structures on the lot •Exlsting and proposed utilitles O <br /> •Centerline of street 9ndicate North •Show any proposed greding changes 'Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <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 pertormed in accordance with this permit and current City of Everert Design and O <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TflLL FREE NUMBER 1-800-424-5555. � <br /> V♦ <br /> O <br /> °UBUC WpRKS PEPM1± � <br /> INITIAL INSPECTION �Y ^'o�EQ��qE� <br /> Y,IRK BROOKS -�-�6 <br /> vATE., L ��� ' <br /> DATE ��"�----- <br /> � � <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned ownedapplicant hereby agrees tu hoid and save harmless <br /> the City of Everett irom any and all claims for damages,costs,expenses,or <br /> Approved for Construcdon p��e causes of action that may artse because of installation and maintenance of <br /> the improvement or other right-of-way use hereto applled for and further agrees <br /> to remove same upon notice from the City and to replace pu6lic property <br /> damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed <br /> Signeture of Applicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST 6E STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLEfION.THIS PERMIT MAY BE CANCELIED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />