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I <br /> DetC___Gf13/82 v„oi�:wo,r�r.,��n ._ __ I <br /> eiea��o�. 37C98 ' I <br /> ApPlication For <br /> PUBLIC WORKS PERII�IT �°°'�w°°.`.° - <br /> ,e,.�.�. s <br /> t�+.eom ree va e= <br /> Print or Type Oniy ��•���o�. 6 � <br /> Victor Wu 3454 NE 94th St Seattle, WA 98115 525-9874 � <br /> Ownei MaibnBAtlCress Cily Z�p P�one <br /> Owner <br /> AOPlican� b1e.''nBAddress COy Zip P�one <br /> Oe�nibBPropcsed�York Z LPst[xm6/Gettdn4 1mplOVemettt (to be lEStauianh) <br /> _ � <br /> ProjectA�E�ess�dknownl __._�403 Sioadway � <br /> Atlec�lo�rt I41 copies of i::•;::��o005eA work•D�aw IO Scale anC note I�C I011owing as appliWble'. � <br /> •Property I.ine� •Cenietlin¢a�sireet /A <br /> •Outbne and�impnsmns ol all e�is�ing and •InEitale Notlh V� <br /> prOposetl Ciruci��:.[�r�he lot •$how any propo5ed gretlinB t�2n0es <br /> •Eaisli�g anG pmnoseC util�ities •Show measuremenls M <br /> W <br /> 00 NOT WflIIE 8[LOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All cells br inspedion shall G?maUe 24 hrs.in aavpnce•phone 259•BB�O. � <br /> 2.All work shell ba pedormed in nccordance wilh ihls permA enE wrrent City ol Ewrelt Deslgn end ConSWdlon <br /> SlandarEs anC Specii�cations. <br /> 3.CaIILucalionUnCerBroundServicede�ra.beloreyouEig.TOLLFPEENUM8ER1-B00•424•5555. � <br /> � �'nm u���,� �� � <br /> ��r��� � I � <br /> ��2 �9� v O � <br /> a <br /> ACKNOWLFDGENENT OF CONOITIONS <br /> T�e undeisigned owneq2pPlican�heieby eyrees t0 ho10 unC cavc�arm� <br /> — less Ihe Ciiy nf Everell Irom any ana all claims tor Oamages. cosls. <br /> Q�pC115C5, O!L3115C9 OI 2CI10�1 IIIdI RIBy dl152 betauss ol inslatlalion <br /> nnd ranlnlenance ol ihn impiovament or other�Ip�1'o��wey use hereto <br /> applietl br antl lurtber agreas tu remove samo upon nulice Irom I�o <br /> ApProveG br ConSbucti0n Datv Ctly and lo replace pWlic pro�erry�amageC thereby. <br /> FlNRL�NSPECTION Da�e -- <br /> AOOrOvetl a4 Conslrucied S�g^aiwe ot Apphcanl Date <br /> � PUBLICWORKSOEPAfiTME�T 1VORK AUTHOFIZF.D BY TMIS PERMIT MIJ51 BE STAPTED WITHIN <br /> 1tl0 DAYS OF �ATE PEFMIT IS ISSUE7 AND TMEREAFTER IS TO <br /> 9200Cetler5lreet BE OILIGENiLY PURSUE�TO COMPLEiION.THIS PERMIT MAY BE <br /> Evaretl,WA990J1 CPNCFLLE�BY TNE CITV UPON ANY STOPPAGE OF WORK ON THIS <br /> Pnona:Y59�Oti10 PROJECT OVER 90 OAYS DURATION. <br />