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Date <br />GpPlicalion For <br />PUBLIC VVORKS PERMIT <br />Print or Type Only <br />Plan Check No: B 39276 SEPA <br />Applicat.Date: O1/19/93 <br />Job P.drlress: 7601 EVERGREEN WY �E-2 <br />Uwner: CASCADE DEV. GAOUP <br />:�enant: HOUSEHOLD FINANCE CORP <br />Owner Proposed Use: OFFICE <br />D�sc. of Work: <br />:.*.. - 30005F <br />Applicant <br />Describe Proposed Work _ <br />Prclect Address (il known) <br />OFFICE SET JOB <br />APPROVED FOR PERMIT: DATE_/_/_ HY <br />Puolic Wad! Parmp � _ <br />01a0. UePI. • <br />'�ohc warks Fao <br />Tolal Fao 5 — <br />Less ADP� Foo PaiO S_ <br />oaiancc nue S _ <br />Phone <br />Phone <br />Attach four (4) copies ol plans for proFosed work - Draw to scale and note the following as applicable: <br />• Property Lines • Centerline ol sireet <br />• Outline and aimensions of all existing and • Indicale Norih <br />proposed siructures onthelot • Show any proposed grading changos <br />• Existing antl proposed utilities • Show measurements <br />NO' WRITE BELOW 7HIS LINE <br />PER M IT COPJ DITIONS <br />1. All calls for inspection shall be made 24 hrs. in advarc? • phone 259•8810. <br />2. All work shall be perlormed in accordance with this permit and current City of Everett Desi�n and Construclion <br />Standards and Specilications. <br />�. Call Location Underground Service 48 hr�. before you dig. TOLL FREE NUMBER 1•800-A24-5555. <br />PUBLIC ;h'ORKS PGRMIT <br />NO', REOUIFIED <br />8 Y��� , <br />DATE � �'r >' � <br />npprovedfor Construc:on Date <br />FINAL INSPECTION Date <br />Approved as ConstructcC <br />�A�PUBLICY/ORKSDEPARTMENT <br />"� 3?.00 Cecar Street <br />� Everett, N.A 9c3201 <br />Phone:2E9���10 <br />ACKNOWLEDGEMENT OF CON�ITIONS <br />f1J <br />f- <br />��w <br />V / <br />M� <br />• <br />� <br />O <br />The undersigned o�vneUapp' :ant hereby agrees to hold aad save harm� <br />less Ihe Clty of Everell trom any antl all claims for tlamages, r.osts, <br />ezpenses, or causes of action �.iat may arise because of installation <br />and maintenance ol the improvement or other righlrobway use hereto <br />appliCd lor and furiher agree; to remove Same upon nolite frGm ihe <br />Cily and lo replace public properry damaged ihereby. <br />Signature ol Applicant Date <br />WORK AUIHOFIZED BY THIS PERMIT MUST BE STARTED WI7HIfd <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />�E DILIGENTLY PURSUED TO COMPLETIUN. THIS PERt.11T �AAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGG OF VJORK ON THIS <br />f�Fi0.1[CT OVER 90 DAYS DURATION. <br />