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Date pumm Won�Parmn• <br /> Ap0liCetion For eiep D.o� • <br /> PUBLIC WORKS PERMIT ^°°�KW°��.F.. <br /> .o�.��.. � <br /> lo��ool fea P��a f <br /> B�I�ne��W f <br /> Prinl or Type Only <br /> Owner Plan Check Nos B 38029 SEPA Z�p Phone <br /> Applicat.Dete: 09/16 92 . <br /> Job Addreee: 2726 EDAA ST <br /> Owners EVERETT LIONS CLUB <br /> Tenent: COCOON HOUSE <br /> Applicent PrOpoeBd UBBi TEEN SHELTER ZiD Phone <br /> Deec. of worki <br /> ADDN OF BATHROOM� SHEETROCR IN EXISTING <br /> Describa P�oponed Work AREAS <br /> OF'FICE SET JOB SET <br /> APPROVED FOR PERMITs DATE_/_/_ BY <br /> -- _ - W <br /> Prolec�Addrees pf known) _ � <br /> Attech lour(4)copiee ol plana lor propo6ad work- Drew lo ecale and note the lollowinp aa epplicable: � <br /> • Praperty Linae • Cenlerline ol streel � <br /> • Outlina end dimnnelone ol all e�lating end • Indicete No�th <br /> propoaed slructuree on the lol � Show eny proposed predinq chengas <br /> • Exlatlnp and proponed ut111tiee • Show meesurementa � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONOITIONS <br /> 7.All calle for Inepectlon ehell be meda 24 hro.In advence•phane 259•8810. � <br /> 2.All worlc eholl be peAormed In eccordence with thle permit end curcent City al Everatt Deelpn and Conelructlon <br /> Stenderde and Speclllcetione. <br /> 3.Cell Locatlon Underpround 3ervice 4B hro.befo�a you dig.TOLL FREE NUMBER 1•800�42Mb555. � <br /> f�LJj��!- l�i^.t�' �t1.,c� C /C.nr ,(e� r�iC� a�i� O <br /> ' ��l� <br /> �� -/ % � � � <br /> � <br /> O <br /> a <br /> ACKNOWI.EDGEMENT OF CONDITIONS <br /> The undersigned owner/ep011cant hereby egreee to hold and eavn harm- <br /> leen Ihe City ol Eva�ett Irom eny and all claima lor demapea, cueta <br /> B�penees, ot Cauaeb ol BC�iOn th0t mey eri6e beCeUae ol ins1811efion <br /> end maintenance ol Iha improvamenl or other rlphl�ol�wey usa hereto <br /> epplied lor end furiher egreea lo remove aame upon notica from the <br /> Approvr.d lor Conatruction Date Clly end to replace Oublic properry demeged thereby. <br /> FINAL INSPECTION Dete .__ <br /> Approved ae Constructed Slgneture ol Applicant Dete <br /> � PUBLICWORKSDEPARTMENT WORK AUTHORI2ED BV THIS PERMIT MUST BE STPHTED WITHIN <br /> 3200CederSlrent 1B0 DAVS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everelt,WA BB201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:259•8810 CANCELLED BV THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAVS DURATiON. <br />� <br />