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Date_ Faille Work:r'nrrna a <br /> Application For rilr+cr.DPW it __..-.. <br /> PUBLIC WORKS PERMIT Public Works Fee <br /> Tolnl Fee $ --.. <br /> Less Ape.Fee Peal $ <br /> Balance Due $ <br /> Print or Type Only <br /> Owner Phone <br /> Plan Check No: B 40771 SEPA <br /> Applicat.Date: 05/28/93 <br /> Job Address: 225 SW EVERETT MALL WY <br /> Owner: TERRA FIRMA DEV CO LTD <br /> Applicant Tenant: JUMP START ESPRESSO BARS Phone <br /> Proposed Use: ESPRESSO STAND <br /> Desc. of Work: <br /> Describe Proposed Work _ PLACE ESPRESSO STAND <br /> OFFICE SET JOB SET <br /> APPROVED FOR PERMIT: DATE / / BY <br /> Li <br /> Project Address(if known) <br /> Attach four(4) copies of plans for proposed work- Draw to scale and note the following as applicable: <br /> • Property Lines • Centerline of street c <br /> • Outline and dimensions of all existing and • Indicate North <br /> • proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements <br /> CI <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS <br /> 1.All calls for inspection shall be made 24 hrs.in advance-phone 259-8810. <br /> 2.All work shall be performed in accordance with 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. mw <br /> C <br /> F <br /> C <br /> C <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> rig-1, r 74.1) The undersigned owner/applicant hereby agrees to hold and save har <br /> less the City of Everett from any and all claims for damages, cos <br /> expenses, or causes of action that may arise because of installati <br /> and maintenance of the improvement or other right-of-way use herF <br /> applied for and further agrees to remove same upon notice from t <br /> Approved for Construction Date City and to replace public property damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed Signature or Applicant Date <br /> PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITH <br /> 3200 Cedar Street 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS <br /> BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY <br /> Everett,WA 98201 i <br /> Phone:259-8810 0 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON TU <br /> SII <br /> PROJECT OVER 90 DAYS DURATION. <br />