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Date •--w � Pu01ic WorA�Permlt• <br /> AppliCation For eiap,oeot• <br /> PUBLIC WORKS PERMIT P����=W��,F�. <br /> Tolal Fe� S <br /> len IooL Faa P�iO S <br /> Print or Type Only Bel�ncs Due ` S <br /> Plan Check No: B 404�7 SEPA <br /> Owner Appllcat.Date: OS/04/93 <br /> Job Addre: 2416 COLBY AVE Z�P Phone � <br /> Owner: EVERfiTT SCHOOL DISTRICT <br /> Tenant: <br /> Proposed Uee: SCHOOL THEATER <br /> Appiicant Deec. of Work: Zip Phone <br /> UPGRADE ADDITOAIUM THEATER <br /> Describe Proposed Work . OFFICE SET JOH SET <br /> - APPRVD FOR PERMIT: DATE_/_/_ BY <br /> Pro�ect Address(il known) � � . � ' <br /> Attach four(4)copies of ptens lor proposed work-Drew to scale and note the(ollowing as applicable: � <br /> • Property Lines • Centerline of street � <br /> • Outline and dimensions ol all existing and • Indicate North <br /> proposed structures on the lot • Show any proposed gred(ng changes <br /> • Existing and proposed utilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1.All cal�s for inspectton shall be mede 24 hrs.in advance•phone 259•881 O. � <br /> 2.Ail work shali be performed tn accordance with this permit and curcent City ot Everelt Design and Construction <br /> Standards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.betore you dig.TOLL FREE NUMBER 1•800-424•5555. � <br /> O <br /> PUB NOTWREOUIRED M'T � <br /> BY 'P' � <br /> DATE s j O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant here6y agrees to hold and save harm- <br /> less the City of Everelt Irom any and all clalms lor damages, costs, <br /> expenses, or causes of action that may arise because of fnstallatlon <br /> and maintenance of lhe improverrent or other right-of•way use nereto <br /> applied lor and further agrees to remove same upon notice trom the <br /> Approved for Conslruction Date City and to replace public property damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed Signature of Applicant Date <br /> PUBLIC WORKS DEPARTMENT WORK AUTHORI2ED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CedarStreet 180 DAYS OF DATE PEfiMIT IS ISSUED AND THEREAFTER IS �TO <br /> Eve�ett,WA9B201 BE DILIGENTLY PURSUED TO COMPLETIO�.THIS PERMIT MAY BE <br /> Phcne:259•8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />