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Date <br />� <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only plan Check No: B 42305 SEPA <br />Applicat.Date: 10/08/93 <br />3ob Address: 14b5A SE EVERET'P MALL WAY <br />, Owner: KEY INVESTMENT PROP <br />Tenant: CASCADE REGIONAL EYE CTR <br />Owner Propoae� Use: RETAIL <br />Deac. of Work: <br />TENANT IMPROVEMENT <br />Appiicant <br />Describe Proposed Work _ <br />Project Address (if kncwn) <br />'_ip <br />Pu[11c Works Parmil ♦ <br />BI�O� DepL e _ <br />Puelie worxs Fea <br />TalalFea S — <br />lnsa PpOL Fae PaiE $ — <br />F�alanee Due S — <br />Phone <br />OFFICE SET JOE SET !ip Phone <br />APPROVED FOR PERMIT: DATE_/_/_ BY <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the (ollowing as applicable: <br />• Property Lines <br />� Outllne and dimensions of all existing and <br />proposed structures on the lot <br />• Existing and proposed utiiities <br />• Centerline of street <br />• Indicate North <br />• Show any proposed grading changes <br />• Show measurements <br />PERMITCONDITIONS <br />t. All calls for Inspectlon shall be made 24 hrs. in advance • phone 259•8810. <br />2. All work shall be performed in accordance wNh this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800•424-5555. <br />PUBLIC WORKS PERMIT <br />NOT qEOUIRED <br />BY � <br />DATE /�%� P�' <br />Approved tor Construction <br />FINAL INSPECTION <br />Approved as Constructed <br />����PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everetl, WA 98201 <br />Phone:259�8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />H <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />The undeisigned owner/applicant hereby agrees to ho�d and save harm• <br />less the City of Everetl from any and all claims for damages, costs, <br />expenses, or causes of action ihat may arise because of installation <br />and maintenance of the improvement or other righhof-way use hereto <br />applied for and turther agrees to remove same upon notice from the <br />Date City and to replace public property damaged thereby. <br />Date <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS �TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />