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��� _ <br /> ,r,� � Date 8 26 91 �... v�e„�woa.ca�' �` <br /> N�� . amv oeo� . 3G S <br /> Application For <br /> " " PUBLIC WORKS PERMIT °°^°°'"°�"`° <br /> �F]� toLl f�e s <br /> ulev�bo�.Feev��u S <br /> �o� Pnnt or Type Oniy _ . ' <br /> TO POSIING_ �.nce0ue S ��s00 <br /> H . . �� . .� � .�.� � <br /> �i�� Filliam P Brust :. _1701 41st StT II103 Everett 259-6622 <br /> p• C] <br /> �M� Owner ', -�� . MaiNng Address City L�p Phone <br /> �M i . .. . �"� . <br /> u M ApPlicant MaJiny Atldr¢ss City Zip PhOnC <br /> W� <br /> y� orscr�ne Proposed Work Construct 3000 sf offices with anartments above <br /> OW _ <br /> � - W <br /> Piojed Address(il known) 40�y � <br /> Ptlach four 14)copies ol plans lor proposed work-Draw to scale and note the lollowing as appliw6le: � <br /> • Pwperty Lines • Cenlerline ol sireet /^ <br /> • Outline and d�mensiona of all e.isting and • Intlicate North V� <br /> proposed structures on ihe lot • Show any proposed prading changes <br /> �- � • EriSting and proposed utilities • Show measuremen!5 /M <br /> I �� DO NOT WRITE BELOW THIS LWE � <br /> 1 � P[RMITCONDITIONS O <br /> _ 1.All cells lor inspection shall be made 24 hrs.In advance-phone 259•8810. � <br /> 1 r � 2.A�I work shall be pedormed in eccordance with Ihis permit and current Ciry of Everelt Design and Construction <br /> a�` Standards and Specilicalions. <br /> '�, 3.Ceil Location Underground Service 48 hrs.belore you dig.TOLL FPEE NUMBER 1-800•424•5555. �y <br /> �j , L <br /> �` `� Cl,cr�• -�o Eic C�or�� �n.e/L mxd� �c�/�� �v�+-�.��- � <br /> I �""�� f?/'a.,,. o<<G-�f /v-' 9! C���. ���.�.G,�J <br /> „ � <br /> i�i � <br /> O <br /> ,-_ a <br /> � <br /> , <br /> �1 � ACKFlOWL[DGEMENT OF CONDITIONS <br /> The undersigned ownei;applicant hereby agrees lo hold and save harm� <br /> less ihe Ciry oi Evereu Irom any and all claims for tlamages, cosls. <br /> � � expenses, or rauses of aclion that may arise because ol installation <br /> ��' G.� and mainlenance ol lhe improve nt m olher righbof-way use hereto <br /> � app�ied lo� and further ac�rees �ei�ove same upon nolice irom Ihe <br /> o d lor onstr �6n - . �e City and lo replace publjc{yop rty d maBed Ihereby. , <br /> ������_ � �'/� '��— i � 1 ��'. � � <br /> FINAL IIJSPECTION Date ��^�°�� � `�� �� � � <br /> Approved as ConstruUed Siqnature oTA �Lcanl Date <br /> � WORK �UTtiORIZED BY THI PERMIT A1UST BE STARTED WITHIN � <br /> ,rr��_ PUBLICWORKSDEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3700 CeGar Streel BE DILIGENTLY PURSU[D TO COIdPLET10N. THIS PERMIT MAY BE <br /> Gverelt.WA 98201 CANCELLED 8Y THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259-8�10 PROJ�C7 OVEf7 90 DAYS DURATIOIJ. <br />