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4' H <br />9 H co <br />H �H <br />K n <br />H X1 <br />'Otl Hot <br />y H <br />CIS <br />H t7 <br />0 Hg <br />MHz <br />HH <br />H <br />adCA <br />19L <br />H O TA <br />Dateb�r/a'- <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Tyoe Only <br />Plan Check No: <br />B 36922 <br />Owner <br />Applicat.Date: <br />06/04/92 <br />Job Addrs: <br />76055 B VERLY BLVD <br />Owner: <br />BITTO, JOHN <br />Tenant: <br />JUNG MOON <br />Proposed Use: <br />MINI MARKET <br />Applicant <br />Desc. of Work: <br />INSTALL GLASS <br />DOOR <br />Describe Proposed V <br />OFFICE SET <br />JOB SST <br />Project Address (if known) <br />Public Vic" Permit e 5,6 / G <br />2. Z. <br />ludo Dept. e <br />Pvetie wort. Fee S <br />Total Fee <br />Len Apol Fat Paid s <br />Balance Due S <br />SEPA <br />Zip Phone <br />APPRVD FOR PERMIT: DATE_/_/_ BY <br />Zip Phone <br />TT. <br />Attach tour j4) copies of plans for proposed work • Draw to scale and note the lollowing as applicable <br />• Property Lines <br />• Centerline of street <br />• Outline and dimensions of all existing and <br />• Indicate North <br />proposed structures on the lot <br />• Show any proposed grating changes <br />• Existing and proposed utilities <br />• Show measurements <br />DO NOT WRITE BELOW THIS L;NE <br />PERMIT CONDITIONS <br />1. All Balls for inspection shell 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 />C_, <br />3. Cell Location Underground Service 48 hrs. before you dig. TOLL FREE NUM BER 1.800-424.5555. <br />! C e <br />i f i�./�'!-Ci Lei r'2.`'-✓ �=r Lr... ( i✓�'•� /a(_.�.e7.e <br />Approved for Construction Date <br />FINAL INSPECTION Dale <br />Approved as Constructed <br />lwfffPUBLIC WORKS DEPARTMENT <br />f 3200 Ceder Street <br />Everett. WA 98201 <br />Phone: 259-8810 <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 rlght•of•' ay 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 Date <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 WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />K <br />9, <br />