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, Application Por <br /> � PUBLIC WORKS PERMIT Date <br /> PUBLIC WORKS DEPARTMENT Public Works Permit tt <br /> 3200 Cedar Street <br /> EveretL WA 98201 259-8810 �uilAing Pertnit p <br /> Public Works Fee 5 <br /> TYPE OR PRINT ONLY <br /> Plan Check No: B 53382 SEPA <br /> Applicat.Date: 10/31�96 <br /> 3ob Addrsae: 2128 ROT�DWAY phone <br /> Owner Owner: TNOHPSON RODGER <br /> Tenantc <br /> PropoOed Uee: AUTO REPAIR <br /> Applicant ' <br /> DADDITIONWTOkCOMMERCIAL BUILDING Phone <br /> Describe Proposed Work _ <br /> OFFICE SET _JOH SET� � <br /> APPROVED FOA PERMIT: DATE_/_I_ BY ` <br /> r <br /> � <br /> � <br /> PROJECT ADDRESS(if known) � <br /> Atlach four(4)copies ol plans for proposed work-Draw lo scale and note the lollowing if applicable: O <br /> •Property Lines •Outline and dimensions of all existing and proposed structures on the lot 'Existing and proposed ulilities � <br /> •Centerline of street •Indicate North 'Show any proposed grading changes •Show measurements <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: <br /> 1. All calls for inspection shali be made 24 hours in advance- phone 259-8810• O <br /> 2. All work shall be performed in accordance with this permit and current City of Everett Design and <br /> Constru�tion Standards and Specifications. � <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br /> V/ <br /> � <br /> �;1PIJC w0�9�5 PFNM�� a <br /> ���O/' 4FGN�l�* <br /> �.Y._LJ. .� _ <br /> YATC_..I�� . yy_._., <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned ownedapplicant hereby agrees to hold and save harmless <br /> the City ot Evemfl from any and all claims for damages,costs,ezpenses,or <br /> causes ot action thal may arise bewase ol installalion and maiMenance of <br /> AppmvedforConstruct'on �a�e Iheimprovementorotherrighl-ot•wayuseheretoappliedforandtvrtheragrees • <br /> to remove same upon notice irom the City and ro replace public propertv <br /> damageA themby. . <br /> FINAL INSPECTION Dale <br /> Approved as Constructed— ' — <br /> Signa'ure of.4pplicant Date <br /> COA4PLETION.RIHEDP RMI7 MA R9E CANCEU ED BYTHE CINIUPONDN SOiOFPAGE OF WIORK ON THIS PFOJEC O ER 90 DOAYSE UILRATIOIttY PURSUED TO <br />