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Date PuCuc WOA�Permn r <br /> Application For ewc.oeo+�• <br /> PUBLIC WORKS PERMIT �ubucWaM1�Fee <br /> To�.�«e s <br /> la���pp�Fee P�iE S <br /> 8����c�Due f <br /> Print or Type Only <br /> . Plan Check No: B 41322 SEPA <br /> � Appli.cat.Date: 07/16/93 <br /> Job Addresa: 2926 COLBY AVE <br /> Owner: HOPKINS JELSING 6 TRI <br /> Tenant: <br /> Owner Proposed Uee: LAW OFFZCE � Phone <br /> Desc. of Work: <br /> TI <br /> Applicant OFFICE SET JOB SET � Phone <br /> APPROVED FOR PERMIT: DATE_/_/_ BY <br /> Describe Proposed Work _ <br /> W <br /> Project Address(il known) � <br /> Attach four(4�copies of plans for proposed work- Draw to scale and note the following as applicable: � <br /> • Property Lines • Centerline of street � <br /> � Outline and dimensions of all exisling and • Indicate North <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Ezfsting and proposed utilities � Show me2surenients � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> i.All calls tor inspectton ahell be made 24 hrs.in edvance•phone 259-8810. � <br /> 2.All work shall be peAormed in accordance with this permit end current City of Everett Design end Conslruction <br /> Slanderds and Specificetlons. <br /> 3.Call Location Underground Service 48 hrs before you dig.TOLL FREE NUMBER 1•80Q-424-5555. � <br /> O <br /> WUBLIC WORKS PEpMIT � <br /> NOT REOUIRED <br /> BV �CATE 7 20 9� , <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm� <br /> less the City of Everett irom any and all claims tor damages, costs, <br /> ezpenses, or causes ol action that may arise because of installation <br /> and maintenance of the improvement or other right•of-way use hereto <br /> applied for and turther agrees to remove same upon notice irom the <br /> Approved for Construction Date City and to repiace public property damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as ConstruCted Signalure of Applicant Date <br /> PUBLICWORKSOEPAFTMENT H'�RK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CedarStreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everel4�'�'A98201 C'E DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:259-8810 CANCELLED BY THE CITV UPON ANY STOPPAGE Of WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />