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� ADPIicaGon For <br /> PUBLIC WORKS PERMIT Date <br /> PUBIiC WOHKS DEPARTMENT Public Works Permit a <br /> 3200 Cedar Street <br /> Everett,WA 98201 259-8810 gullding Permit M <br /> 7YPE OR PRINT ONLY Public Works Fee S <br /> Owner Plan Check No: B 53693 SEPA Phone <br /> Applicat.Date: 12 06/96 <br /> 7ob Addreee: 28 7 COLHY AVE <br /> Owner: SKOTUAL ART <br /> Tenants CO}1STAL COMtdUNITY BANK <br /> Appii:ant Ptopo�ed Vaet BANK Phone <br /> Deec. of Works <br /> PARTIAL REFACE BUILDINC <br /> Describe Proposed Wcrk _ W <br /> OFFICE SET JOB SET � <br /> APPROVED FOR PERMITs DATE_/_/_ BY _ <br /> � <br /> PROJECT ADDRESS(if known) /y� <br /> Atlach four(4)coples of plans for proposed viork-Draw to scale and note the following if applicable: �++ <br /> •Property Lines 'Oulline and dlmensions ol all existlng and proposed structures cn the lol •Ezisting and proposed utllities O <br /> •Centerline of street •Indicate North •Show any proposed gradinq chanpc� •Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: Z <br /> 1. All calls for inspection shall be made 24 hours in advance-phone 258-8810. O <br /> 2. All work shall be pertormed in accordance with this permit and current City of Everett Design and <br /> Construction Standards and Specificatlons. <br /> 3. Call Location Underground Service 48 hrs. before you dic�. TOIL FREE NUMBER 1-800-424-6555. H <br /> V♦ <br /> O <br /> a <br /> '•UPLIC WONKi �@Pti��' <br /> ro0� Cfi0WR6� <br /> yA74_._�j..�! 9 `P__....._ <br /> � <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> � The undersigned ownedaoplicant hereby agrees to hold and save hartnless <br /> the City of Everett from any and all clalms for damages,costs,expenses,or <br /> causes of actlon that may arise because of Installatlon and meintenence of <br /> ApprovedforConstruction Date theimprovementorotherright-of-wayuseheretoapplledloraridfurtheragrees <br /> lo remove same upon notice from the City and to replace public property <br /> damaged thereby. <br /> FINAL INSPECTION Oate <br /> Approved as Conslruded <br /> Signature of Appiicant Date <br /> WORK AU7HORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PEHMIT IS ISSUED AND THEREAFfER IS 70 BE DILIGENTLY PUFSUED TO <br /> COMPLEf10N.THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON 1HIS PROJECT OVER 90 DAYS DURATION. <br />