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Date � <br />Applicelion For <br />PUBLIC WORKS PERMIT <br />Print or Type Oniy <br />'� weucwan.r.,mn. <br />�' eie,)o.ot.• <br />>umcwo�x�r'ee S <br />ra�ire� <br />lH� A00� F�� PUE S <br />Btl�m�Dua S <br />Plan Check No: 8 40257 S6PA <br />Applicat.Date: �4/15/93 Zip Phone <br />Owner Sob Addreae: 16b5 SE EVERETT MALL WAY <br />Ownet: HAGCEN INC <br />Tenant: STAABUCK'S <br />Propoeed Uee: AETAIL <br />Applicenl Daec. of Work: Zip Phone <br />AETAIL <br />Descri0e Proposetl Wt OFFICE SET JOB SET <br />APPROVEp FOA PERMIT: OATE_/_/_ gy�_ - — <br />Cra�acl Address QI known) <br />Attach lour (4) copies ot plans lor proposed work - Draw lo scale antl nole ine lollowing as appllwble: � <br />• Properly Lines • Cenledine ol streel <br />• Oulline and dimensions ol ell existing and • Indicale Norlh <br />proposed structures on I�e lot • Show any proposed gratling changes <br />• Ezislin9 antl proposed utilitios • Show measuremenis <br />PERMIT CONDITIONS <br />1.All calls lor Inspectbn shall ba matle 24 hrs in sdvance • phone 259•8810. <br />2. All work shall be perlormed In accordance with this permit and current City oi Everett Design and Conslructlon <br />Standards and Specilicallons <br />3. Call Location Underground Servica 48 hrs belore you dig. TOLL FREE NUMBER 1•800-424•5555. <br />PUBLIC WORHS PEpMIT <br />NOT REOUIRED <br />�Y � <br />DATE ��/.�_ <br />Approved lar Con3ifuctlon Dalo <br />FINAL INSPECTION Date <br />Approve0 as Consiruclotl <br />Pl18LIC WORKS DEPARTMENT <br />3200 Codar Slrect <br />Evaw14 H'R 98201 <br />Phon8:259•OB10 <br />ACKNOWLEDGEMENT OF CON�ITIONS <br />�'7 <br />■ <br />� <br />�� <br />� <br />Z <br />O <br />� <br />�/ <br />O <br />a <br />T�e unCerslgneG owner/aOD���N heie6y aBrecs to hold and save �arm- <br />less Ihe Clly ol Everett Imm any antl all claims lor damage& cosls, <br />expenseS or causes ol aclion Ihal may arisa becau:a ol inslallation <br />and mainlenance ol Ihe impmvement or other tighbo4way use hereto <br />appliod lor antl lutlhF • agrees to �emovi� same upon nolice Irom the <br />Cily and lo replaca puenc pw0erty tlamaSod Ihereby. <br />Signalure o� AppliCanl Oale <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 PEflMIT MAY BE <br />CANGELL'c� BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />