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.,� <br /> . � � <br /> � <br /> �: ;,� <br /> -� _. <br /> ;< ------ -- -- <br /> �.� , <br /> DfltO ' woue wan+vermn• <br /> Application For emc.oeo�• <br /> PUBLIC WORKS PEF�MIT �uoucwodsFee <br /> Tpill Fee `S <br /> ry.��� Leef P npl Fa�Gt�G $ <br /> Cay <br /> ,�y x Print or Type Onry Balanae Oue s <br /> ar�fHA I <br /> H �:t Plan Clieck No: H 276A6 <br /> H H Applicat.Date: 09/OS/91 <br /> K y� Owner J�b Addreae: 8625 EVERGREEN WAY Phane <br /> Sepa Number: <br /> Owner: HARMON & ASSOC <br /> � �H Proposed Use: OFFICE <br /> y �yr Applicant De,� 7000�SF Phone <br /> � y� � <br /> ON <br /> � �t7 Descri6e Proposed Work OFFICE SET JOB SET � <br /> H� nq • __ APPAOVED FOR PERIiIT: DATE_/_/_ BY i <br /> z H t+7 i , ' <br /> � �H W <br /> H Prolect Address(if known) � <br /> CC�] Cq1 CA <br /> 3 L�]� Attach four(4)copies of plans tor proposed work• Draw to scale and note ihe following as applicable: s <br /> �ti y� • Property LineS • Cen�erline of Street /A <br /> �� O fA • Outline and dimensions of all existing and • Indicate North V� I <br /> - � proposed siructures on the lot • Show any proposed grading changes <br /> • Ezisting and proFosed utilities ' • Show measuremenis � <br /> DO NOT WRITE BELOW THIS LINE O <br /> � PERMIT CONDITIONS <br /> 1.All calls for inspection shall be made 24 hrs.in advance•phone 259•8810. � <br /> �'�e 2.All wcrk shall 6e pedormetl in accordance wilh this pennit and current Ciry of Everett Oesign and Cunstruction <br /> .�i Standards and Specifications <br /> 3.Call Locaticn Underground Service 48 hrs before you dlg.TOLL FREE NUMBER 1•800�4245555. � <br /> �� � <br /> �� .�( n_ o <br /> I �L I • <br /> /v��-GLC/GZ<'1.�'Y•v+c�/�/O'7F(%i[lF�u't� � � <br /> 0 I <br /> yl� ��/� <br /> � <br /> 'Ov� � � <br /> � �I I <br /> �.w� ' 1 <br /> M1 i�� I <br /> ACKNOWLEDGEMENT OF CONOITIONS <br /> �'� <br /> � The undersigned owner/applicant hereby agrees to holtl and save haim- <br /> less Ihe City ot Everett from any antl all claims for damagea costs <br /> expenses, o� causes ol action lhat may anse because of 'nstallation <br /> antl maintenance of the improvement or other ngh4obway uce hereto <br /> �y�,__� applietl tor and turther agrees lo remove same upon notice Irom the � <br /> ApProved for Const�uction Date Ciry and to replace public properry aamaged thereby. , <br /> I <br /> � <br /> FINAI INSPECTION Date � <br /> Approvetl as Consiructed Signature ot Applicant Date , <br /> /�r�� PUBUC WORKSDEPARTMEN7 WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN ' <br /> 780 DAYS OF DATE PERMITIS ISSUED AND THEREAFTEfl IS TO <br /> � 3200 CedarStreet BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMI7 MAY BE <br /> � Everett,WA 98201 CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:25&8010 PROJECT OVER 90 DAYS DUFATION. <br />