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Date 1� 1"USI�NUZ�rT � � _ _ <br /> PUEIic Warks Permll• <br /> Application For ' eiav�oeo�.• <br /> PUBLIC WORKS PERMIT PUbTotelFee�Be : ��� <br /> L89a AOGt Fae PaiG S <br /> Print or Type Only B,�a��eo�a s_l�Y�� <br /> JAMES RUSSELL 4211 — 200TH SW STE#103 LYNNWOOD WA 98036 672-8150 <br /> Owner MaiNng Address ; , Ciry � 2ip Phone � <br /> WASHINGTON CREDIT UNION (TENANT) � � � <br /> Applicant Mailing Addrecs Ciry Zip Phone <br /> � � � <br /> Describe Proposed Work �V-('.t,�Y / l <br /> � Project Adtlress(if known) 1►102 - �: r '(#1 � � <br /> Attach four(4) copies of plans for proposed •�^�4- Draw to scale and note the following as applicable: � <br /> • Properry Lines • Centerline of street � <br /> • Outline and dimensions of all e;+sting and • Indicate North <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements <br /> DO NUT WRITE BELOW THIS LINE � <br /> � PEkMITCONDITIONS O <br /> 1.All calls for Inapectbn shatl be made 24 hrs.in advance-phone 259-8810. � ' <br /> 2.All work shall be peAormed in accordance with this permit and current City of Everett Design and Cansiruction <br /> Stendards and Spaciftcations. <br /> 3.Cell Locatton Underground Servlce 48 hrs.before you dig.TOLL FREE NUMBER 1•500-4245555. � <br /> �• �2'i' ,�/J�i'o`^1��� ��rf�� Cv ' �' g,j O <br /> / <br /> � <br /> � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> . The undersigned owner/applicant hr.reby agrees to ho1G and save harm- <br /> � less ihe City of Everett irom any and all claims for damages, costs, <br /> expenses, or causes of action that may arise because of installation <br /> � � �' and maintenance of the improvemernt or other righFof-way use hereto <br /> Approved f ConstruD on applied for and further agrees to remove same upon notice from the <br /> Date Ciry and to lace blic p�operty damaged thereby. <br /> ! / / � � � <br /> FIN L INSPECTION D te '� ` <br /> Approved as Consiructed <br /> ignati of pplicant Dat <br /> PUBLIC WORKS DEPARTMENT �NO A HORIZED BY THIS P � MUST BE STARTED WITHIN <br /> 3200CedarStreet 180 S OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA98201 BE D IGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BE <br /> Phone:259-8810 CA ELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> P JECT OVER 90 DAYS DURATION. <br />