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Dete _ ►wnewon.vmm�. _ <br /> Appllc�tlo� �r ��Di�� <br /> PUBLiC WORKS PERMIT �^�W�^��� <br /> ran r•� • <br /> Lu�Appl FN Ptl0 � <br /> B�4nd Dw { <br /> Print or Type Only <br /> Plen Check Noi B 40600 SEPA <br /> Applicat.Detes OS 13 93 <br /> Job Addreses 25 5 CASINO RD /8D <br /> Owners CUSHIN6 GROUP II <br /> Tenant: EXECUTIVE PRODUCTS <br /> OWnl1 Propoeed Ueei OFFICE/WAREHOUSE :Ip Phon1 � <br /> Deea. of Works <br /> TENANT IMPAOVEMENT <br /> Appllc�nt OFFICE SET JOB 6ET ��P Phonu <br /> APPROVED FOA PBRMITt DAT6__/_/_ BY <br /> De�crlbs Propo�ed Work _ <br /> W <br /> Pro�wt Addree�(il known) � <br /> Attwh lour(�)coplss of pl�m lor propo�ed work•Pnw to ecals end note the followinp���ppllcable: � <br /> • Propsrty Lins�� �Cenlarllns of etnat � <br /> • Outlin��nd dimenslon�of�II exi�tinp�nd • Indic�ts North <br /> proposed�tructuro�on the lol • BAow�ny propoaad qndlnp chenpse <br /> • Exbtlnp�nd propwed utllltls� • 9how ms�eurament� � <br /> DO NOT WRITE EL W HI9 LINE O <br /> PERMIT CONDITION9 <br /> 1.All cdls fw In�pectbn�h�ll bs m�ds 24 hrs.ln adv�nce•phone 269�8810. � <br /> 2 All work�hrll bs psAormsd In�xord�nce wlth thle permlt and curront Clry of Everott Dapn�nd Connruction <br /> Bt�nd�rd�end Bpeclfiwtlona <br /> 3.GII Loatlon Underyround Bervlce 4B hn.beforo you d�p.TOLL FlIEE NUMlE111•800�4246666. � <br /> O <br /> PUBI.IC WORKS p � <br /> NOT REpUIRED�M�T � <br /> BY,� <br /> DATE�3/�� ' O <br /> ��=.� <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersipned owner/ep0liunt hereby apreee to hald�nd e�ve herrtr <br /> lees ths City of Everell irom any end �11 clalms lor dema0e0. cost0. <br /> . e�penee0. 0� eausee ol aotlon t��t mey �rlse becaues of Inetallellon <br /> end malnten�nce ol lhe improvemenl or other ripht•of•w�y use herato <br /> epplisd lor and further ap�ee� to remove s�me upon notice Irom the <br /> Approved for Con�liuctian � Dale Clty and lo replace public property demeped thereby. <br /> FINAL INSPECTION Date <br /> Approved as Conetructed Sipnature ol Appllcent Oate <br /> � PUBLIC WORK9 DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MU9T BE STARTED WITHIN <br /> 3200CeduSlrost 180 DAY3 OF DATE PERMIT IS ISSUED ANO THEREAFTER IS �TO <br /> Everott,WAB8201 8E DILIOENTLY PUR8UED TO COMPLETION.THIS P[FMIT MAY BE <br /> Phons:266•8810 CANCELLED BV THE CITY UPON ANY STOPPAOE OF WORK ON THI3 <br /> PROJECT OVER BO DAVS DURATION. . <br />