Laserfiche WebLink
Application For �'�. <br /> � PUBLIC �. �ORKS PERMIT °` - <br /> PUBUC WORKS DEPARTMENT Public Works Pertnit q . <br /> 3200 Cedar Sheet <br /> Everett,WA 982Q1 259•8810 Building Permit M <br /> 7YPE OR PRINT ONLY Plan Check No: B 51123 sEPA <br /> 'orks Fee$ <br /> Appl=cat.Date: 03/18/96 - <br /> Jab Addre: 4914 �`lERGREEN WAY <br /> Owner: MGMAB LTD phone <br /> Tenant: MAIL BOXES ETC <br /> Owner Propoeed Use: RETAIL <br /> Desc. of Work: <br /> TENANT IMPROVEMENT <br /> Phone � <br /> Applicant JOB SET <br /> OFFICE SET <br /> Describe Proposed Work APPRVD FOR PERMIT: DATE_/_I_ BY W <br /> � <br /> � <br /> N <br /> PROJECT ADDRESS(if known) {�I <br /> Attach four(4)coptes of pians for proposed work-Draw to scale and note lhe tollowing if applicable: O- <br /> •Property Lines 'Outline and dimenslons ot all existing and proposed structures on the Iot •Existing and proposed utillties � <br /> •Centerline of street •Indicate North •Show any proposed grading changes •Show measurements <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: O <br /> 1. All calls for inspection shall be made 24 hours in advance-phone 259-8810. <br /> 2. All work shall be performed in accordance with this permit and current City of Everett Design and <br /> Construction Standards and Specifications. � <br /> 3. Call Location Undergro�ind Service 48 hrs. before you dig. TOLL FFiEE NUMBER 1-800-424-5555. � <br /> O <br /> a <br /> ;�UBLiC LyORKS PERM�' <br /> p;p'f qEUU1REP <br /> 4Y� ' <br /> :.ATE_ 3 lQ/pb -- <br /> - ACKNOWLEDGEMENTOFCONDITIONS <br /> The�ndersigned owner/applicant hereby agrees to hold and save harmt:�s <br /> the City ot Everett trom any and all claims for�amages,costs,expens��s,or <br /> causes of action that may arise because of Installation and mainten,nce of <br /> ApprovediorConstruction Date thelmprovementorotherright•of-wayuseheretoappliedforandtuAheragrees <br /> to remove same upon notice from the Ciry and to replace pub�!.: properry <br /> damaged thereby. <br /> FINAL INSPECTION Date <br /> �� Approved as Constructed <br /> licant Oate <br /> � Signature of App' <br /> � COMPLEfION.TIH S PERMIT MAY BE CA JCELBLED BY THE CINIUPON ANY 5�T0 PAGE OF WORK ON THIS PROJEC 0 ER 90 DAYS DULRATIONLI'PURSUED TO <br />