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��� <br />��x <br />C H <br />�Hy <br />H�H <br />tC C] <br />H h7 <br />"�dH� <br />V1 N�+ <br />�OLTI <br />HC <br />OH <br />�^�8 <br />y,Y � <br />t-� y � <br />gyy <br />C�CCf�/� <br />isl��+J <br />�HN <br />HOtn <br />Date <br />Application For <br />PUBL�C WORKS PERMIT <br />F:int or Type Only <br />Owner <br />Appli�ant <br />Describe Propased Work _ <br />Proiect AOdress lil known) <br />Plan Check No: <br />Applicat.Date: <br />Job Addreen: <br />Owner: <br />Tenant: <br />Propoeed Uee: <br />Deec. of Work: <br />4005F ADDITION <br />B 35597 SEPA <br />0260�/92 <br />83 0 bEVEALY BLVD <br />DZCKSON CYNTHIA <br />HAIR SALON <br />OFFZCE SET_ JOB SET <br />APPROVED FOR PF.RMIT: DATE_/_/_ BY <br />c�oim wo�.a ve�mn . <br />o ea om� • _ <br />r'„o��cwo�+sree S <br />,o.,, F., — <br />�ese Aoc� F+n �am 5 <br />9.vm�eo�> S <br />A�toch lour (4) copies of plan5lo� proposed work - D�aw to sc31e antl note Ihe I�Ilowin9 as applicable: <br />• Property Lines O Cent?ninr ol ;treet <br />• Outline antl aimens�ons ol atl eaishng ano • InC.c�tc North. <br />proposed structure. on the lot • Show any propwea gradmg rnanges <br />• Existing antl proposetl uUtihes • Show measurements — <br />Phone <br />Phone <br />'�� PERMIT CONDITIONS <br />1. All calls lor inspeclicn shall be made 24 hrs. in advance • phone 259•8810. <br />2. All work shall be perlormed in accordance with this permit and currem Ciry ol Everett Design and Construction <br />'�/ Stantlards and Specificallons. � <br />3. Call Location Under9round Service 48 hrs. belore you dig. TOLL FREE NUMBER 1•800•424•5555. <br />�i <br />lor Construction <br />{,',� �; �. �•���r k�s ��Ef m'.� 1Jot. �.e�.� t red <br />v <br />c <br />f � u,�1Z 1-'1 �s� <br />Date <br />=1NAL INSPEGTION Date <br />�pproved as Constructed <br />�ArO�PUBLIC WORKS �EPARTMENT <br />J200 Cetlar Sireat <br />Everel4 WA 98201 <br />Phone:259•8810 <br />3—��—�z <br />� <br />� <br />� <br />� <br />0 <br />a <br />ACKNOWLEDGEMENT OF CUNDITIONS <br />The undersigned owner/appi�cant �ereby agrees to hold and save harm� <br />I less the City ol Everett Irom any antl all claims lor damages. wsts. <br />I�expenses. or auses o: action lhat may arise because o� installation <br />and mairtenance ol ihe improveme�t or oth�•r righFol�way use hereto <br />applied lor and larther agrees lo remove same upun notice Imm t�e <br />Cily and to replace public property damaga0 lhereby. <br />Signature ol AppliCanl Dale <br />WORK AUTHOFIZED BY THIS PEFMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND "fHEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BE <br />CANCELLED BY THE GTY UPON APJV STOPFHGE OF WORK ON THIS <br />PROJEC70VER 9U DAVS DUNAiION. <br />