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D2lC � a.m.cworvav.imn. <br /> Applicalion For B10p o•°�• _ <br /> PUBLiC WORKS PERMIT °�°,o;:;::`°• � <br /> levApO�feeV�iE S <br /> Babn[eDue 5 <br /> Print or Type Only <br /> Plan Check No: 8 40489 SEPA <br /> Appllcat.0ate: OS/OS/93 <br /> Job Addre: 3030 SE EVERETT HALL WAY <br /> Ownar Owner: EMOP ASSOCIATES Zip Phone � <br /> Tenant: NJRWEST MORTCAGE <br /> Propoaed Use: OFFICE SPACE <br /> Deec, of Work: <br /> Applicant TENANT IMPROVEMENT Zip P�one <br /> OFFICE SET JOB SET <br /> Describe Praposetl Work <br /> APPRVD FOR PERMIT: DATE_/_/_ BY <br /> W <br /> Prolect Address(il known) . � <br /> Atlach lour(4)conies ol plans lor Oroposetl work�Draw to scale antl nole tne loltowing as applicable: � <br /> • Pioperty Lines •CeNedine ol sireet /A <br /> •Outline end dimensions ol all e�isting antl • Indiw�e North �� <br /> proposed siructu�es on Ihe lot •Show any propoSeC graCing changes <br /> •Exisling antl p�aposud ulililies •Show measuremenis � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All calls for inspection shall he mado 24 hrs.In advance�phone 259•8870. � <br /> 2.Atl work shall he petlormed in accordanca wllh Ihis permit nnd current City of Everell Design antl Construction <br /> Slandartls anE Specifiwtions <br /> 3.CnIILocalionUndergmund5ervice4bhrsbelorayoudid.TOLLFHEENUMBEfl1•800•424•5555. � <br /> O <br /> PUBLIC WOAKS FERMIT � <br /> NOT REOUIRED I— <br /> BY S' Y% <br /> �ATE 's U `-, O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The vaaersi9ne0 owneqapplicant hereby agrees lo hold and 5ave hai m� <br /> less I�e City ol Evere�t Irom any and ali claims lor tlamages. costs, <br /> =�penses, or causes al action ihat may erise because ol installa�ion <br /> and maintenance of Ihe impmvement or olher iiPh4obway use hereto <br /> appticd br and Wrther agrees lo removn same upon notice imm Ihe <br /> ' Approvetl lo�ConsVULllon Dale Cily and�o�u01ac¢public pro0erty damag¢d�hereby. <br /> FlNAl.INSPECTION Da�o <br /> �ppmve0 as Consimcled SigwWre ol Ap0liwnt Oale <br /> � PUBLIC WOFKS OEPARTMENT WORK AUTHORIZED BY THIS PERA7IT lAUST BE STARTED WI�hIIN <br /> %e'�1 9200Cetlar5lreet 180 OAVS OF OATE PERMIT IS ISSUED AND THPREAFTER IS TO <br /> ��T�� Everel4H'A98201 BE DILIGENTLY PUf15UED TO COMPLETION.THIS PEFMIT MAY BE <br /> �'� Phone259�8810 CANCELLEDBVTHECITYUPONANYSTOPPAGEOFWOflKORTHIS <br /> PROJE^.T OVER 90 DAYS Ol1RATION. <br /> _ � <br />