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� . ...lication For ., <br /> PUBLIC VrJRKS PERMIT Date �_ ,.��� <br /> PUBLIC WORKS DEPARTMENT Public Works Permit k <br /> 3200 Cedar Street <br /> Evnrett,WA 98201 259•8810 <br /> Building Permit N <br /> TYFE OR PRINT ONLY Public Works Fee S <br /> Owner MaIIIngAtl pinn Check No: 8 50949 ggpA 1e <br /> App.icat.Date: 02/22/96 <br /> 3ob Addreae: 4012 COLBY AVE <br /> Owner: HRUST WILLIAM p <br /> Applicant MailingAc Tenart: ie <br /> Propoeed Uee: OFFICE <br /> Deec. of Work: <br /> DeECflb2 PfOPOSOd WOf1C ___ . T•I• TO LOWER FLOOR OF 2 STORY BLDG � <br /> OFFICE SET JOB SET � <br /> APPROVED FOR PERMIT: DATE_/_� gy �� <br /> _ /w <br /> V� <br /> PROJECT ADDRESS(if known) _ � <br /> , Anach tour(4)copies of plans for proposed woric-Drew to scale and nole the following if appilcable: O <br /> � •Property Lines 'Outllne and dimensions of all existing and proposed structures on the lot •Existing and proposed utllities <br /> •Centerline of street •Indicate NOAh •Show any proposed greding chai�ges •Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: 2 <br /> 1. All calls for inspection shali be made 24 hours in advance-phone 259-8310. O <br /> 2. AI!work shall be pertormed in accordance with this pertnit and current City of Everett Design and <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � _ <br /> v♦ <br /> O <br /> ,:URLIC '�+�ORKS PEPM�' /\ <br /> ��O�' 4ECIUIPE� 1�� <br /> lAT���� 9�_ <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned ownedapplicant hereby agrees to hold and save harmless <br /> ihe City of Everett from any and all ciaims for damages,costs,expenses,or <br /> Approved tor Construction Date causes ol action that may adse because o1 installation and maintenance o( <br /> the improvement or other right-of-way use hereta applied for and further agrees <br /> to remove same upon notice from the City and to replace public pmperty <br /> damaged thereby. <br /> FINAI.LVSPECiION Date <br /> Approvod as Constructed <br /> Signature of Applicant Date <br /> V:�ORK AUTHORIZED BY 1�IIS PERMIT MUST BE STAFTED WIiHIN 1B0 DAYS Of DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURSUED TO <br /> C0.'dPlEll01J.THIS PERMIT MAY BE CANCELLED E3Y THE CI7Y UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />