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C�ate <br /> , PuClie Worka Permlf r <br /> Applicatlon For eiay.oao�.+ <br /> PUBLIC WORKS PERMIT PuCIlcWorkaFeu <br /> ,o�,�Faa s <br /> Lese Appl FBB Paid $ <br /> Print or T�pe Only ea�a��ao�a s <br /> Owner Plan Check No: B 40226 SEPA phone <br /> Applicat.Date: 04/13/93 � <br /> Job Address: 86Z5 EVERGREEN WY <br /> Owner: E.B.C. ASSOC <br /> Tenant: SOCIAL SECURITY <br /> Applicant Px�opoaed Uae: OFFICE Phone <br /> Desc. of Work: <br /> T.I. — INCREASE SPACE BY APPROX 2000SF <br /> Dr:scribe Proposed Work _ <br /> OFFICE SET JOB SET <br /> APPROVED FOR YERMIT: DATE_�_�_ gy <br /> Project Address(if known) � . � .' � <br /> Attach four(4) copies ol plans for propos�d work- Draw to scale and note the fol�owing as applicable: � <br /> • Property Lines • Centerline of street � <br /> • Outline and dimensions uf all existing and • Indicate North <br /> proposed structures on the lot • Show any proposed grading changes <br /> O Existing and proposed utilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE �\ <br /> PERMITCONDITIONS l ) <br /> 1.All cails for inspection shali be made 24 hrs.In advance-phone 259•8810. �� <br /> 2.AII work shall be performed in accordance with this permit and current City of Everett Design and Construction � <br /> Standards and Specificatlor,s . <br /> 3.Call Location Underpround Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800-424•5555. � <br /> O <br /> � <br /> pUBLIC WORKS PERMIT �/\ <br /> NO�� EUUIREO \/� <br /> BY ` O <br /> DATE �' �s ' � � <br /> � <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br /> less the City of Everelt trom any and all claims for damages, costs, <br /> expenses, or causes of action that may arise because of installation <br /> and maintenance of ihe improvement or other righl-of•way use hereto <br /> applied lor and furiher agrees to remove same upon notice Irom the <br /> Approved lor Consiruction Date City and to replace pubiic property damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed Signature of Applicant Date <br /> ������ PUBLICWORKSDEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200Cedar5lreet 180 DAYS OF DATE PERMIT IS ISSUED <.ND THEREAFTER IS �TO <br /> Everett,WA98201 BE D�LIGENTLY PURSUED TO COMPLETION.THIS PEHMIT MAY BE <br /> Phone:259•8870 CANCEILED BY THE CIl'Y UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />