5506 S 3RD AVE 2016-01-01 MF Import

TYPE OR PRINT ONLY Applicaoon For PUBLIC WORKS PERMIT PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everetl, WA 98201 (425) 257-8810 Dat� Public Works Permit M 8-30-99 euilding Pertnit H C9908-025 Public Works Fee $ Dina Sergeyev 5506 S 3rd Ave Everett 98203 425 303-0236 Owner Mailing Adtlress City Zip Phone AppGcant MailingAtltlicss City 2ip Phone Describe Proposed Work adding living space to PROJECTADDRESS (ii known) Altach lour (4) copies plans for proposed work - Draw to scale and note the lollowing il applicable: • Property Lines • Uutline and dimensions of all existing and proposed s�ructures on the lol • Ezisting and proposed utilities • Centedine ot street • Indicate North • Show any proposed grading changes • Show measurements DO NOT WRITE BELOW THIS LINE PERMIT CONDITIONS: 1. All calls tor inspection shall be made 24 hours in advance - phone (425) 257-8810 2. All work shall be periormed in accordance with this permit and current Ciry ot Everett Design and Construction Standards and Specifications. 3. CaII Locatinn Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-B00-424-5555. 'Uo��r, voo aKs I�GT � r4NNJa I R tiv� 11'.. �_ � �A7E.,.,_ q '' _._ _..J. pprove or onsrucion a e FINAL INSPECTION Appmved as Constructed Date W � Y• ACKNOWLEDGEMENT OF CONDITIONS Thc undersigned owner/applicant hereby agrees to hold antl save hartnless the Ciry of Everett �rom any and all claims for damages, cosis, expenses, or causes ol action Ihat may arise because ol installation and maintenance of tho improvement or other right�ol-way uso hereto applied for aM further agrees to remove same upon notice Irom the City and to replace publ�c property dam- aged there6y. igna ure o p ican a e VJORK AUTHOfiIZED CY THIS PERMfT MUST BE SL1RfED 1NfT}iIN 180 DAYS OF DAlE PERMIT IS �SSUED AND 7}iEREAFfER IS TO BE qLIGENfLY PURSUED TO COMPlET10N. TH:3 PERMR MAY BE CANCELLEp pY THE CfTY UPON ANY SlYWPAGE OF VJORK ON THIS PROJECT OVER 90 DAYS DURATION.