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Date <br />Application Fm <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Owner <br />Applicant <br />Describe Proposed Work _ <br />Froiect Address (d known! <br />Plan Check t7o: B 45164 SEPA <br />Applicat.Date: 08/04/94 <br />Job Addcess: 509 N BROADWAY <br />ONner: WSDOT <br />Tenant: <br />Proposed Use: SAND STORAGE <br />Desc. of Work: <br />ERECT PRE-FAB FAHRIC-COVERED STEEL-TRUSSED <br />STORAGE BLDG ON BLOCK FOUNDATION <br />OFFICE SET JOB SET <br />APPROVED FOR PERMIT: DATE_/_�_ <br />.i <br />PuOi�c Worb Permit � _ <br />Bleg Depl + <br />Puhbc Worts fee <br />TO�RI ipp .S _ <br />LPSe 40D1 FpP Paitl 5_ <br />eaia��e o�e S _ <br />� Phone <br />> Phone <br />Attach four (4� copies ot plans lor Uroposed work � p�av: to ,r„�i�� ,i;,n nUe thr. !oiluwing as apU��cabie: <br />� F�onerty Lines <br />• Outline and dimensions ol all exis}ing antl <br />propo5etl siructures on Ihe lol <br />• Exis�ing and proposed utilities <br />• Center6nA pl street <br />• Irdiwte North <br />• $how any r,roDosed grading changey <br />• Show measuremenis <br />uv rvvi wnnt dtLUW THIS lW[ <br />PERMIT CONDITIONS <br />1. All calls for inspection shail be made 24 hrs. in advance - phone 25�J•A81 O. <br />2. All vrork shall be pedormed in accordance with this permit and current Cily ol Everett Design and Construction <br />Slandards and Specifications. <br />3. Call Location Underqro�nd Service 48 hrs. before you dig. TOLL FREE NUMBER 1-$00-424-5555. <br />Approved tor Construction <br />:'UBLIC WORKS PERMIT <br />NOT FiEOUIRED <br />3Y _ <br />�ATE `�' �— <br />ACKNOWLECGEMENT OF CONDITIONS <br />� <br />\/ <br />_ 7hr �.indFr�iqnetl owner/applicznt he�eby igrees to hold and sace ha�m� <br />� less the Cily of Everelt Irom any and all claims lor damages. costs. <br />i expenses. or causes of action that may anss because ol instal�ation <br />; and mamtenante o! the improvement or other riqhDnbway use hereto <br />— � d�n��ed for anA lunher agrees to remove same upon notiCc 'rom Ihe <br />���'' � C��:y antl to replaca pub6C property damaged Ihereby. <br />FINAL INSPECTION � Date <br />AUAroved as Construded <br />� PUBLIC WORKS DEPARTM�NT <br />'V��3200 Cedar Slreet <br />EveretL WA 9B2G7 <br />Phone:259-8810 <br />Siqnalur� ot App6tant Date <br />WOfiK AUTHORIZFD BY 1-IiIS PERMIT MUST BE START[D WITHIN <br />7A0 DAYS OF D�TE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLV PURSUED TO COMPLETION. THIS PERMIT IdAV B[ <br />CANC[LLED B'! THE CITY UPON ANY STO�PAGE OF WORK ON i HIS <br />FqOJEC.i OVER g0 D�lYS DURATION. <br />