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Date ��z 7���0 � r j Puo�ic Wods Permn• <br /> Application For eiao oeo�.• 90/26007 <br /> PUBLIC WORKS PERMIT P��IicWorkafce <br /> ,o�a�Fe� s <br /> teas nooi.Fee Pn�a S __ <br /> Print or Type Only 68�a�=eo�e s <br /> R M Dulin & Son, inc. 2217 Broadway Everett 98201 <br /> Owner MaiVing Atldress Clty Zip Phone <br /> Grey T. Lundberq & Co, Inc. 920 NE 64th St Seattle 98115 526-1861 <br /> Applicant Mailing Address City Zip Phone <br /> Descdbe Proposed work Tenant improvemeot & Addition to Cocmnercial Building <br /> W <br /> P�ojed Address li1 known) 2217 BLOddWay L- <br /> r <br /> � Atlach four(4)copies of plans lor pwposed work- Draw to scale and note the tollowing as applicable: �� <br /> • Property Unes • Centerline ot sveel ♦I� <br /> • Outline and dimensions of all existing �nd • Indicate Norih v <br /> proposed slructures on Ihe lot • Show any proposed grading changes <br /> • Ezisting and proposed utilities • Show measurements �� <br /> - DO NOT WRITE RELOW THIS LINE <br /> PERMIT CONDITIONS � <br /> 1.Ali calls tor inspection shall be made 24 hrs.in advance•phone''c59•8810. � <br /> 2.All work shali be peAormed in accordance with this permit and curre�N City of Everett Design and Construction <br /> Stanrlards end Specifications. <br /> 3.Call Location Underground Service 48 h�s.before you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> O <br /> ��,J W����� �/� � <br /> � � ��� ��B�iov�-- �t�,l/4�('" cfihi��.°c_/.,;� � <br /> � _ Q O <br /> I/—G/—yO -- <br /> � a <br /> �(��/�.IS> •/�f S(l�GUi/!��,/ • <br /> � <br /> ��� �� � - <br /> / , / �/ <br /> The unAe ryt G� h t �r� � re harin- <br /> " �ess the �� � 1 � s, rosis. <br /> eapense /� / /�P�.��� �� /� 1alla�ion <br /> and mai /"�'U Y 1r��� e he�eto <br /> — ,nni��d ._. / �f ' �J `vc�.C� Irom ihe <br /> ApproVP.d for Construction Dale G�y and lo replace pubhc prope„y ,,.... <br /> FINAL INSPECTION Date <br /> Approved as Consirucled Sianature of Apptiwnt Date <br /> everetl PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> � 3200CedarStreet 180 DAYS OF DA7E PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everetl,WA98201 BE DILIGGNTLY PURSUED TO COMFLETION. THIS PERMIT MAY BE <br /> Phone:259�8810 CANC[LLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DUFATION. <br />