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r <br />�� <br />Date 1/13/84 <br />Application For <br />6�UBLIC WOF3KS PERMIT <br />Print or Type Only <br />Pu�lic Works Perml� a f <br />Bldg. Dept. • 84/128 4 <br />PublicWo�k9Foo g �O m9 <br />Tolal Fae <br />Less AppL Fee Paitl � �— <br />Balance Due $ � ' � � <br />�7�9s <br />Special Interest Auto Body, Inc. 6900 Evergreen Way Everett 98203 353-2381 <br />Owner Mailing Address City Zip Phone <br />Berhold Const. Corp 3606 142nd Place N.E. Bellewe 98007 981-5010 <br />Applicant Mailing Address City Zip Phone <br />Add addition to existing body and paint shop <br />Describe Proposed Work <br />Project Address (if known) 6400 <br />Attach tour (4) copies of plans for proposed work • Draw to scale and note the following as applicable: <br />• Property Lines 6 Centerline ot street <br />• Outlfne and dimensions ol all existing and U Indicate North <br />proposacl structures on the lot • Show any proposed grading changes <br />• Existing and proposed utilities • Show measurements <br />PERMIT CONDITIONS <br />1. All calls tor inspection shall be made 24 hrs. in advance • phone 259-881 5. <br />2. All work shall be performed in accordance with this permit and cu« enl City of Everett Design and Conslruction <br />Standards and Specifications. <br />3. Call Localion Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1•S00•424-5555. <br />�, �iC� S�IKC �• lJ. � (G Z� V� r� C..fV'ni WtVL.S�✓J� <br />� �e � � � �.. � �o �� I �.�-e. � <br />�-c �/ �. ��(Q„ Q �� b�( � <br />� � ..� e e� e <br />f�Gl Y �.. �J 1�— LN w1�� ��. ��� <br />�,� � I ` �o <br />S. I .�j lN .� � �.o t d P�.. t d� lM 9�....r � � � � <br />5.1� � G../ \ �1�' ` I <br />QrN.h�G ��low � �vr�v n,..—s�d-� C. �. S. <br />Approved as <br />everett <br />� <br />PUBLIC WORKS U <br />3200 Cedar Streel <br />Everett, WA 98201 <br />Phone: 259-8815 <br />ENT <br />� <br />� <br />A <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City of Everett from any and all claims for damages, costs, <br />expenses, or causes of action that may arise because of installation <br />and maintenance of lhe improvement or other right-ol-way use hereto <br />applied for and turther agrees to remove same upon notice from the <br />City an�place public �op�a�+'S�ed�e� <br />/� iyi. - ' "JV�O <br />3�y�� Date <br />9ignature of Appli .ant <br />WORK AUTHORIZED BY THIS P MIT MUST BE STAATED WITHIN <br />180 DAYS OF DATE PERMIT ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WOFK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />a <br />