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e <br />�d <br />Date <br />� <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Oniy <br />�~ IPUEIit Work� P�rmN • <br />BI00� D�pL � _ <br />PUEIit Workt F�a <br />Tot�l Fsa S <br />Let� AooL Faa P�IO S <br />BWnpDu� � <br />SEPA <br />eppiicac.uace: us/vn�yo Applicat.Date: os/oa/9s <br />Job Addrese: HLDG A Job Address: BLDG B <br />Owner: PORT OF EVERETT pwner: PORT OF EVERETT <br />- Tenants DUNLAP TOWING Tenant: DUNLAP TOWING <br />Propoeed Uee: SHOP Propoeed Uee: WAREHOUSE <br />Deec. of Work: Deec. of Work: <br />NEW MAINTENANCE SHOP CONSTRUCT NEW STORAGE BLDG <br />f <br />OFFICE SET JOH SET OFFICE SET JOB SET <br />_ APPROVED FOR PERMIT: DATE_/_/_ BY_ APPROVED FOR PERMIT: DATE_/_/_ BY_ <br />Pf� ................... ... ..�,... .., <br />Attach four (4) copies of plans for proposed work • Oraw to scale and note the following as applicable: <br />� Property Lines • Centeriine of street <br />• Outline and dimenaions of all existing and • Indicate North <br />proposed structures on the lot • Show any proposed grading changes <br />• Exiating and proposed utilities • Show measurements <br />PERMIT CANDITIONS <br />1. All calla for inapectbn shall be mede 24 hrs. in advence - phone 259-8810. <br />2. All work sAall be performed In accorclance with thfe permit and curtent City of Everett Design and Construction <br />Standards and Specificatlona <br />3. Call Lxatian Underpround Service 48 hra before you dig. TOLL FREE NUMBER 1-800�4245555. <br />�UBLIC yypqK <br />�"aY pEOUIpE���T <br />•--.�..�_ tY ,.,!/� <br />•--�L <br />DATE_�l0 9s <br />Approved (or Construction <br />Date <br />FINAL INSPECTION Dale <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Ceder Street <br />Everett, WA 98201 <br />Phone: 259•8810 <br />J <br />� <br />� <br />� <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/epplicant herebyagrees to hold and save harm- <br />less the City of Everett irom any end all claims tor damages, costs. <br />expenses, or causes of ection that mey arlse becauae uf installation <br />and maintenence of the� improvement or �other riphhof•way use hereto <br />applied tor and furihe� egrees to remove seme upon notice (rom ihe <br />City and to replace public property damaged thereby. <br />Signature ol Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />18U DAVS OF DATE PERMIT IS ISSUED AND THEREAFTER IS �TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />