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`� ..:.�cation Far . <br /> PUBLIC WJRKS PERMIT Date <br /> PUBLIC WORKS DEPARTMENT Public Works Pertnit q <br /> 3200 Cedar Street <br /> Everett,WA98201 259-BB70 <br /> Bullding Pertnit# <br /> NPE OR PRINT ONLY Public Works Fee$ <br /> Owner Mailir PpBn Check No: B 50181 SEPA <br /> A plicat.Date: 11/30/95 Phone <br /> Job Addreee: 9029 $L CAPITAN WY <br /> Owner: COMMUNITY TRANSIT <br /> Tenant: <br /> APP����� Malllr Propoaed Uee: AESTROOM Phone <br /> Desc, of Work: - <br /> RESTROOM FOR COACH OPERATORS <br /> Describe Proposed Work <br /> OFFICE SET � JOH SET W <br /> APPROVED FOR PERMIT: DATE_/_�_ gy � <br /> � <br /> PROJECT ADDRESS(if known) � <br /> Attach four(4)copies ol plans 1or proposed work-Oraw to scale and note the fol�owing if applicable: W <br /> •Property Lines 'Outline and dimensions of all existing and proposed structures on the lot •ExlsNng and proposed utilities <br /> 'Centedine of street •Indicate North •Show any proposed grading changes •Show measurements � O - <br /> DO NUT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspection shall be made 24 hours in advance- phone 259-8810. <br /> 2.All work shall be pertormed in accordance with this permit and current City of Everett Design and O <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> V♦ <br /> O <br /> a <br /> �UBLIC WORKS PEPM�' <br /> 1vOr E�UIRE!� <br /> 8Y�__ - <br /> 4ATE_.�� `I S . <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harmiess <br /> the City of Everetl Irom any and all claims for damages,costs,expenses,or <br /> Approved lor Construction pa�o causes of action that may arise hecause ol installation and maintenance of <br /> the improvement or other right-of-way use hereto applied for and lunher agrees <br /> to remove same upon notice from lhe City and to replace put�lic propeAy <br /> damaged Ihereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed <br /> Signalure of Applicant Date <br /> WORK AUTHORIZED 8Y THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMR IS ISSUED AND 7HERFi�F7ER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLETION.THIS PEFMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WOFK ON THIS PROJECT OVER 90 DAYS DURATION. <br />