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Date <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Plan Check No: B 44/09447 <br />Owner APpp/ <br />VOID Address: 35311OAKES AVE <br />Owner: HILL PALE <br />Applicant <br />Tenant: <br />Desclooad Use: CARPORT / SFR <br />SEPA <br />NEW •300SFoCARPORT — ADD DECK TO ROOF OF <br />EXISTING CARPORT <br />Describe Proposed Work _ <br />OFFICE SET <br />�JOB <br />SET <br />APPROVED FOR <br />PERMIT: <br />DATE_/_/_ <br />By <br />Project Address (11 known) <br />Public Works Pormlt <br />Sus Dept a _ <br />Public Works FN <br />Total For, <br />Lou AMA FN Paid $ -� <br />alliance Dw It <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: • Property Lines • Centerline of street <br />• Outline and dimensions of all existing and • Indicate North <br />Proposed Structures on the lot rs Show an • Existing and proposed utilities y proposed grading changes <br />- •Show measurements <br />Phone <br />Phone <br />PERMIT CONDITIONS <br />1- All calls for inspection shall be made 24 firs. In advance - phone 259.8810. <br />2. All work shall be Performed in accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications, <br />3 Call Location Underground Service 48 hrs, before you dig. TOLL FREE NUMBER 1.800•424.5555. <br />PUBLIC WORKS PERMIT <br />NOT REOUIRED <br />By 9B <br />DATE / �9 <br />Approved for Construction Date <br />FINAL INSPECTION <br />Approved as Constructed Date <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett WA 98201 <br />Phone: 259.8810 <br />z <br />O <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agree& 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 property damaged thereby. <br />Signature of Applicant Date <br />WORK AUTHORIZED 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 PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />