Laserfiche WebLink
Date G zLZ" <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br /><lan check No: B 36875 SERA <br />Owner Applicat.Date: 06/01/92 <br />Job Addre: 6308 EVERGREEN WAY <br />Owner: PAY N PAK HOME CENTER <br />Tenant: AL'S AUTO SUPPLY <br />Applicant Proposed Use: BUILDING MAINT WORKSHOP <br />Desc. of Work: <br />TENANT IMPROVEMENT <br />Describe Proposed Work <br />OFFICE SET _JOB SET_ <br />-- APPRVD FOR PERMIT: DATE_/_/ <br />Project Address (if known) <br />13Y <br />I_, <br />p11, Works POW1 <br />131dg.DepL• <br />Public Wp�ks Fee eu <br />Total Fee <br />Less APPI Fee Paid $ <br />Balance Due $ <br />Phone <br />Zip Phone <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: <br />• Property !.Ines • Centerline of street <br />• Outline and dimensions of all existing and • Indicate North <br />proposed structures on the lot • Show any proposed grading changes <br />• Existing and proposed utilities • Show measurements <br />PERMIT CONDITIONS <br />1. All calls for Inspection sha!I be made 24 hrs. 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 />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone: 259-8810 <br />n <br />z <br />O <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees 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-cf-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 Dale <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 WORT: ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />