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M <br /> � � � � � PUEIic Worb Pormil• <br /> H Date__— <br /> CN oiov.oeo�.+ , <br /> 7 ytrq� m Application For <br /> " z �UBL.IC WORKS PEF��iiIT <br /> r Pubbc Waeks Fca <br /> H z n <br /> K, To�a�Fen <br /> � d � Lesa Aoo�Foe Pa�E S <br /> � N H <br /> Balance O�a $ <br /> Print or Type Only <br /> M y � — <br /> d <br /> � � � Owner Plan Check No: M 38159 SEPA phone <br /> x r+ Applicat.�ate: 09/25/92 . <br /> � y Job Address: 52b0 EVEAGREEN WAY <br /> H Owner: HP.IEN MOTORS <br /> Tenant: <br /> c�j p r~n ApplicaM � Propused Use: EODY SHOP Fhone <br /> � c� � Deec. of Work: <br /> PAINT SPRAY BOOTH <br /> y p � � Describe Proposed Work <br /> OFFICE SET JOH SET <br /> APi'ROVED FOR PGRlfIT: DATE_/_/_ BY �o <br /> � <br /> Project Address(if known) � <br /> Attach fuur(4)copies ol plans lo�proposed work- Draw to scale and note ihe following as applicable: � <br /> • Property Lines • Cenledine of street ♦A <br /> • Outline and di;nensions of all existing and • Indicate North V� <br /> proposed s;ructures on the let • Show any proposed grading changes <br /> • Existing and proposed utilities • Show m�:asurements � <br /> ���. � <br /> ���' �' �. DQ NOT WRITE BELOW THIS LI�JE +' <br /> ��',: � � <br /> I '��. � PcRMIT CONDITIONS �� <br /> , � 1.All calls for inspeciion shall be made 24 hrs.in advance•phone 259•8810. � <br /> � � 2.All work shall be pedormed in accordance with Ihis permil and current City ot Everell Design and Construcllon <br /> IS�andards and Specilicalions <br /> �'� 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800•424-5555. � <br /> �r� <br /> � O <br /> ja'� <br /> ...,�' /% <br /> 1 ��.c, l,0lr��'h��tin.r�-� '�� ,����o,� ♦�^ <br /> i V� <br /> ; O! _�/ <br /> i, (••� : `�,J � <br /> �;t"= l- �s. y � � <br /> ., '.o�o' . . . ... <br /> esp� ' .. . `.r.... <br /> I � ACKN0IVLEDGEMENT OF CONDITIONS <br /> f��� � The undersigned owneriapplicanl hereby ac�rees to hold and save harm- . <br /> +n' ��� less lhe City ol Everet� Irom any and all claims for damages, costc, <br /> expenses, or causes of aclion thal may arise because of installa�i�in <br /> � and maintenance of lhe improvement or olher righ4obway use her.to <br /> applied lor and luriher agrees to remove same upon notice Irom the <br /> Approved lor Construction Date City and to replace public property damaged thereby. <br /> PINAL INSPEC710N Date <br /> Approved�s Consirucled Signature ot Applicant Dale <br /> � /�p� PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTFD WITHIN <br /> 3200CedarStreet 780 DAYS OF DATE PERMIT IS ISSUED AND THEFEAFTER IS TO <br /> Everelt,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION.THIS PEPMIT MAY F3E <br /> Phono:259�8870 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS OUHATION. <br />