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J4 / � <br /> Date 1/11/95 � � S Pu01¢WorksPermit• '�' nG��{T� <br /> ''� POSTING 7 �—4 aiec oeai . 46699 <br /> Applicalion FpS , <br /> PUBLIC WOi�K,� PERMIT PuOlicWorksFee - <br /> « <br /> Ta�a��eo s <br /> o �ess npoi.FPe aa��a S <br /> [i ' <br /> Print or Type Only r g o � ea�a��a o�e S �3 ���' <br /> N � � : 00�'-z��S�C�/?�,^_� <br /> in r,i .r r%? <br /> General Teamsters No. 38 2601��'Eve3r�ft �e Everett 98201 <br /> o� <br /> Owner Mailing dce co City Zip Phone <br /> ;: oo � w <br /> Jeff Moore 259-0868 q a �il � L <br /> Applicant Mailing Address City Zip ph,oru <br /> Describe Proposed Work Addition to existing building <br /> W <br /> Project Add�ess(if known) 2601 EVex'etC AVe � <br /> Attach four(4)copies of plans lor proposed work• Draw to scale and note the following as applica6le: � <br /> � Property lines • Centerlir.e of street � <br /> • Outline and dimensions ot all existing and • Indioale North <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements � <br /> DO NOT WFITE 9ELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> i.All cells for inspection shell be made 24 hrs.in advance•phone 259•8810. � <br /> 2.All work shall be pertormed in accordance with this permit and current City of Everett Design end Construction <br /> Standards and Specifications. <br /> 3.Call Location Underground Service 48 nrs.before yc::�iq,TOLL FREE NUMBER 1-800•424•5555. � <br /> � /�y�n,r�- .Sic�l�,�zl,� �is ,f/pc✓:� Oi� Sif f�C.�., O <br /> 5���,�,;rr-d /-/�-9s <br /> S �//! L�X�ra� �%'e y�[�hxn7� /S /"�y(Jir�O� � <br /> Y / � <br /> �or �iS �raJec�; LOCa�i�.+ fi 6e aPP�u✓ec�' <br /> 6y �ie �.-e /'narJ�tLL , O <br /> a <br /> �� \/ ACKNOWLEOGEMENT OF CONDITIONS <br /> ;' The unde�signed ownenapplicant hereby agrees to hcld and save harm� <br /> ,/ less tha Clty ot Everell Irom any and all claims tor damages, costs, <br /> � . expenses, or causes ol action that may arise because of installation <br /> , �����„/;y /�3/�y and maintenance of ihe improvement or other right-ot-way use herr.to <br /> applied lor and furiher agrees to remove same upon notice trom the <br /> Approved for Construction ate Ciry and lo replace public properry damaged thereby. <br /> � ��Q <br /> �-�rn-��_ �•/� - l`�1_ <br /> FINAL INSPECTION Date �� � �' �� <br /> Approved as Constructed � i a e 6YApplicant Date <br /> �A�� PU�LIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PE IT MUST BE STARTED WITHIN <br /> 3200CedarStreet 1f10 DAYS OF DATE PERMIT IS ISSUED AND 7HEREAFTER IS TO <br /> Everett,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Phone:259�8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br /> . <br />