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� <br />�I <br /> r '� <br /> Date 1�17�85 PuOlic Worwe Permii e �✓� -?+ <br /> I eioo.oeot.• 85/14355 <br /> Application For — <br />` PU[3LIC WORKS PERAIlIT PUbTo�FeePoe s _ <br /> I' • <br /> Lesc AOCt Fea PaiE S <br /> Print or Type Only eais�oa o�e 5 ����0 <br /> J�3 �� <br /> Plaid Pantry 2540 N.E,. Riverside Way Por.tland, Oregon 97211 503-288-9216 <br /> Owner Mailing Address City Zip Phone <br />� Westwood Corp 7611 South 180th Kent 98032 251-0638 <br /> Applicant Mailing Address City Zip Phone <br /> Construct Retail Store <br /> �escribe Proposed Work — <br /> � <br /> Project Address(if known) � � <br /> Attach four(4) copies of plans lor proposed work- Draw to scale and note ihe following as applicable: �� <br /> • Property Lines • CeMerline of street ♦� <br /> • Outline and�imensions o�all exis�ing and • Indica�e North V� <br /> proposed sirudures on the lot • Show any proposed grading changes <br />' • ExiSting and proposed utililies • Show measurements � <br /> DO NC�\NRITE BELOW THIS LINE O <br />� PERMIT CONDITIONS <br /> t. All calls for inspection shall be made 24 hrs. in advance- phone 259•881 5. � <br /> 2. All work shall be performed in accordance wilh this permit and cwrent Ciry of Everett Design and Construction <br /> Slandards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig.TOLL FREE NUM6ER 1•800-424•5555. �r <br /> � T 8F �sT.u�C�-o ds r��,� �u�z� � <br /> Ai'f'•E'rx�c-o d.� 2 -z a-8s �� <br /> S, L�LGEr"/ To �'� Pa�co t',��a.� Tv �X'c�i�a�/� � <br /> V♦ <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned Owner/applicant hereby agrees to hold and save harm� <br /> less the City ol Everett irom any and all claims lor damages, costs, <br /> / ' /) expenses, or causes of action ihat may arise because ol installatirtn <br /> �-�-�F�O�� /�`� ���O�ps and maintenance ot Ihe improvement or other right-o4way use hersw <br /> �f� ��Y�� u applied lor and lurther a�rees to remove same upon notice Irom the <br />- Approved for onslruclion Date City and to replace public property damaged ihereby. • <br /> ' /"�/f/,�.2'� s' 2 2—PI'— ? � � <br /> �FIIVAL INSPECTION Date <br /> Approved as Conslructed Si nature ol li ant � Date <br /> evereU PUBUC WOFKS DEPARTMENT �v�RK AUTHORI dY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200 Cedar Sireet 180 DAYS OF DATE PERMIT IS I;iSUED AND THEREAFTER IS TO <br /> �I Everett,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone: 259�8815 CANCELLED BY THE CITY UPON ANY STOPPAGE Of WORK ON THIS � <br /> PROJECT OVER 90 DAYS DURATION. <br />