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�.. I <br /> �/ ���i ` Public Wodf Permil• <br /> ti Datel._L.— �T �y� <br /> . � �+ �C eiao.oaoi.. -.�— <br /> Application For <br /> _ � � PUBLIC WORKS PERMIT Po01¢Y/orhaFee ` <br /> ,o�a�.�o s <br /> N <br /> Leas ApO�Fce PaiG 5 <br /> H 7: <br /> K � Baianca Duo $ <br /> o � o Prinl or Type Only <br /> ro � m • <br /> N H <br /> O tyi � Maillnn aAn•o=^ SEPA Phone <br /> Owner <br /> H �w � plan Check No: B 37497 � <br /> � • ppplicat.Date: 07(Z4�VERGREEN WAY �T8 <br /> � H Job nddress: 48s5 _ <br /> 7 y � Own�r: TERRANOMICS Nhone <br /> r ppplicant Tenant: DZSPLAY 6 CoSTUME SUPPLY <br /> O u~i Propoeed Use: RuTAIL/COMNERCIAL <br /> R O N Desc. of Wo[k: COMBINE SPACES 7, 8 6 <br /> � C � Describe Proposed Work _ 9ENANT IMPROVEtAENT ( <br /> ltl ) <br /> O N OFFiCE SET_�J�g SET�� <br /> APPROVED FOR PERMIT: DATE�I_�— BY � . <br /> Project Address(if known) — — � <br /> Attach lour(4)copies of plans lor proposed work-Draw to scale and note the tollowing as applicable: � <br /> Y Property Lines • Cenledine ol street 'A <br /> • Oulline and tlimensions ol all existing and • Indicale Norih V� <br /> proposed structures on Ihe lot J Show any proposed gradinB changes <br /> • Existing and proposed utilities • Show mexsurements � <br /> DO NOT WFITE BELOW THIS LINE O <br /> ��� - --,1 PERMITCONDITIONS <br /> ��,, 1.All calls for inspection shall 6e made 24 hrs.In advance-phone 259•8810. �\ <br /> � � a� � 2.All x•ork shall be pertormed in accordance with thls permit and current City ol Everett Design and Constmctlon ♦ <br /> � � StandardsandSpecilications. <br /> � . 3.Call Location lJnderground Service 48 hrs.bebre you dig.TOLL FREE NUMBER 1-B00•424•5555. � <br /> � O <br /> �� <br /> � � <br /> �� r�vl��-� C-ri � =f� /2����i��;, � , <br /> ;��<z ��z_.., <c�. . . �( <br /> �� ; �/� <br /> � �� ' � -Z7 % Z V/ <br /> i �s' � <br /> � <br /> +. �.�, <br /> e I,`' � ACKNOWLEDGEMENTOFCONDITIONS <br /> IThe undersigned owner/applicant hereby a9rees lo hold and save harm� <br /> � � less the Cily of Everell Irom any and all claims tor damages, costs, <br /> �. eapenses, or cawes ol aclion ihat may arise hecause oi Installa�ion <br /> =' � and maintenance of the Impmvemenl or olher righPobway use herelo <br /> t applied lor and lurther agrees to remove same uGon notice Irom �he <br /> � �Approved lor Construction Date Cily and lo replace public property tlamagetl I�ereby. <br /> FINAL INSPECTION Dale Date <br /> Approved as Consiructetl Signature ol Applicant <br /> WORK AUTHORIZED 8Y THIS PERMIT MUST BE STARTE� WITHIN <br /> PUBLIC WORKSDEPAR7MENT 190 DAYS OF DATE PERMIT IS ISSl1ED AND THEREAFTER �S TO <br /> 3200CednrSlreet BE DIlIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY EE <br /> Everoll,YlA98201 CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259�eB10 PROJECT OVER 90 DAVS DURATION. <br />