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� � - <br /> Date v�mio wa,w ae,mi�. <br /> BIEg.De01.• <br /> Application For <br /> PUBI�IC WORK5 PERMIT PublicWoikSFee <br /> TolalFee g <br /> Less A00�Fee Paid � <br /> Balanca Oue $ <br /> Print or Type Only <br /> Plan Check No: B �11303 SEPA <br /> Applicat.Date: 07/14/93 <br /> Scb Address: 1010 SE EVERETT MALL WAY <br /> Owner: HARMON ASSOC <br /> Tenant: OLD REPUBLIC TITLE/ESCROW iP Phone <br /> Owner Propose3 Use: OFFICE SPACE . <br /> llesc. of Work: <br /> TENANT IMPROVEMENT <br /> ApplicaM .ip Phone <br /> OFF'ICE SET JOB SET <br /> APYROV�;D FOR FERMIT: DATE /_/_ BY <br /> Describe Proposed Work _ — <br /> W <br /> Prolect Address(if known) . � <br /> Attach four(4)copies of rlans for proposed work• Draw to scale and note lhe following as applicable: � <br /> • Property Lines • Centerline of sireet ♦A <br /> • Outline and dimensions of all existing and • Indicate North V� <br /> p�cposed siructures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements � <br /> �'_ DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1.All calls for inspection shall be made 24 hrs.in advance•phone 259•8810. �\ <br /> 2,.All work shall be performed in accordance with this permit and current Cily of Everett Design and Construction ♦ <br /> Standards and Specifications. o� <br /> 3.CaIILocationUndergroundService48hrs.beforeyoudig.TOLLFREENUMBERI•80 OU64I5�5 WORKS PERMIT / <br /> NOT REQUIRED �� <br /> 9Y O <br /> PUBUC wORKS PERMIY DATE — <br /> NOT R[OUIRED � <br /> BY <br /> PUBLIC WORKS PERMIT <br /> DAT€ - � <br /> NOT �OUIRED O <br /> BY___�7�� "" � <br /> DATE 7 �'� P'� -_"_' <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicanl hereby agrees to hold and save harm- <br /> less the City of Everetl from any and all claims for damages, costs, <br /> . er.pen�es, or causes of action that may arise because of installation <br /> and maintenance of the improvement or olher right�of-way use hereto <br /> applied for and further agrees io remove same upon notice irom the <br /> Approved for Conslruction Oate City and to replace public property damaged thereby. <br /> FINAL INSPECTION Date Date <br /> ApProved as Constructed Signature ol Applicant <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> PUBLIC WORKS DEPARTMENT 180 �AYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS �TO <br /> 3200CedarStreet BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Everetl,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS � <br /> Phone:259�8870 PROJECT OVER 90 DAYS DURAl10N. <br /> \ <br />