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Date <br />Applfcatlon For <br />PUBLIC WORKS PERMIT <br />Pfiflt Of Type Only plan Check No: B 46679 <br />Applicat.Date: O1/09/95 <br />Job Addrese: XX <br />Owner: CIRCUIT CITY STORES <br />Tenant: CIRCUIT CITY <br />Owner Proposed Uee: RETAIL <br />Deac. of Work: <br />NEW RETAIL BLDG (EV&RGREEN FORUM) <br />Applkant <br />Describe Proposed Work . <br />Project Addre�s (if known) <br />� <br />SEPA 63-94 <br />INC <br />OFFICE SET JOB SET <br />APPROVED FOR nERMIT: DATE_/_/_ By <br />Publit Works Permit • <br />Bldq. DeD�. • <br />PUEIic Worb Fee <br />TOUIFee S <br />Leaa �p0� Fee PaiG S <br />Balance0ue S <br />ZiP Pnone <br />ZiP Phune <br />Attach tour (4) copies of plans for proposed work • Draw to scale and note the tollowing as applicable: <br />• Property Lines • Centerline ot street <br />• Outline and dimensions of all existing and • Indicate North <br />proFosed structures on the lot � Show any proposed grading changes <br />� Existing and proposed utilities • Show measurements <br />PERMIT CONDITIONS , <br />� 1. All calls for inspectlon shall be made 24 hrs. In advance - phone 259-881 O. <br />2. All work shall be performed in accordance with this Fermit and current City of Everett Design and Construction <br />Standards and Specifications <br />3. Call Location Underground Servfce 48 hra before you dig. TOLL FREE NUMBER 1-800•424•5555. <br />� `lYCvi� Ci{� <br />�. /(l _�i»'i <br />�,�Ac i s,—Q:E <br />Approved tor Ccnstructian <br />OGt%GS � �G G �i� GS TO_=/TiL I�//f/4!t/i0/1 <br />✓ <br />T frc <br />f. a'GiS�= <br />/Ss,�d� Li.ur�C S���i✓r_-�� - <br />7-s� r(��DAriii� ��,eNr_.c� <br />� ; ��� <br />— <br />rUBLIC. WOqKS PEAAl1T <br />no r- uu+Reta �c,� 4 �y <br />!fY, <br />OATE /� ��4-9 S' <br />FINAL INSPECTION <br />Approved as Constructed <br />PUBLIC WOFKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 982U7 <br />Phone:259•8810 <br />Date <br />Date <br />rss«.�a� <br />W <br />� <br />_ / <br />� <br />V♦ <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to nold anJ save harm• <br />less the City of Everett from any and all ciaims for damages, costs, <br />expenses, or causes af aclion that may arise because of installation <br />and m,.intenance of ihe impravement or other right-of-wc.y use hereto <br />applied (or and further agrees to remove same upon notice from the <br />City and to replace public praperty dart�aged thereby. <br />Signature ol App�icant Date <br />WORK AUTHORIZED BY 7HIS PEflM1T MUST 6E STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS �TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PFRMIT MAY BE <br />CANCELIED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />� <br />