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� MDliwiion For / ' <br /> ���� RUBLIC WORKS PERMIT Date_ 1-23-98 <br /> PUBLIC WORKS DEPARTMENT Public VJcrks Permil M —���/ �Z� <br /> 3200 Cedar Street � <br /> Everett.WA98207 259-BB70 BuildingPetmilN 57702 <br /> TO POSTING APR�= publicWorksFeeS ���00 <br /> IYPE OR PRINT ONLY -- <br /> Greg Campbell 902 E Maple Arlington 98223 360 435 5323 � <br /> Owner Mailing Address City Zip Phone <br /> Owner <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work Addition for clinic W <br /> � <br /> ��/� <br /> �.i.:-,_.- cs _�.7 V♦ <br /> PROJECT ADDRESS(f known) 1425 Broadway `' `'' �'`` <br /> ..U,Lif ' ' � <br /> .�� �.�_,.> � <br /> Anach four(4)copies ol plans lor pmposed work• Draw to scale and note the fotlowing if applicable: . _.�., i�:.����.�.; <br /> •Propeny Lines 'Outline and dimensions of all existing and proposed structures on the bt •Existing and proposed utili4es�.���,` <br /> •Centedine of street •Indicale Nor1h •Show any pmposed grading changes •Show measurements'':'= - � ��- ' <br /> ;r•�,:- - � I <br /> DO NOT WRITE BELOW THIS LINE Z;�Tp� ;-,_,. <br /> PERMITCONDITIONS: _ __. Z- <br /> _.. _ <br /> 1.All calls for inspection shall be made 24 hours in advance- phone 259-8810. q �1;i4�.cc O <br /> 2.All work shall be performed in accorda�ce with this permit and cuRent City of Everett Des'igri and <br /> Construction Standards and Specitications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-4245555. � <br /> � lljo�^r�' �o � dv�e �r �t�p,Os-ove� � � <br /> �L4ti dct �e o� ��o <C.'oPy a �f'a che d� O <br /> 2_�.�e a <br /> ,� cS'io� fecve�^ ro 6e /nS7��CLeo� �e�^ <br /> C�`f S�`u.�d � ��'/� 6oz BO¢ , <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undcrsigned owner/applicant hereby agrees to hold and save harmless <br /> ✓1 _� Z ,.�p-��$ the City ol Everett irom any and ail claims for damages,costs,ezpenses,or <br /> �� — causes o1 action thal may arise because of installation and maintenance o1 <br /> Ap rovedl9 Con;t� i ���e theimprovementorolhernght•o( +vayusehereloappliedforandtuAheragrees <br /> � / to remove same upon notice Irom the City and to replace public property <br /> / � )3�� d maged Ihereby. <br /> O� <br /> F NAL NSPEC Date . <br /> Approved as Constmcted � A ` \ � � <br /> \ � D te <br /> Signatuie\�o plica <br /> INORK AUTHORI2ED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT I5'iSSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLEfION.THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORKbN THIS PROJECT OVER 90 DAYS DURATION. <br />