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Date P��o�,���,o,w.Pa,m��, <br /> App!icalicn For eiay oeoi • <br /> PUBLIC WORKS PERMIT P�����=W�«=F�e — <br /> iotai Gee S � <br /> Less 400i Fne PaiU S <br /> Print or Type Only ea��«o�� 5 <br /> Plan Check No: B 44418 SEPA <br /> Applicat.Date: OS/18/94 <br /> Job Address: 1010 SE EVERETT MALL WY #104 <br /> Q�v�p� Owner: HARMOIJ & ASSOC phonc <br /> Tenant: MONEY STORE <br /> Proposed Use: OFFI(:E <br /> Desc. of Work: <br /> ___ TENANT :MPROVEMENT _ <br /> qpplicant Phone <br /> OFFICE SET JOB SET <br /> Describe Proposed Work — pppROVED FOR PERMIT: DATE BY -- <br /> —�—�— <br /> -------. _. ..._._------------ <br /> -----------------------�-- � <br /> Project Address Uf knowN .__ __._.____. ___, � <br /> A��ach f0ur('11 coPies ot Pians fo� UroUused wo'� � Crav: to .�r,ii:e a:�.a ncte the'oi!G,.viny�s aDGlicab�e. �� <br /> • ProPerty Lines • Cent�rlin? nf streu� ,^ <br /> • Outline and dimensions ol all exis!ing and • IrCicate Nnrth v� <br /> proposetl structures on Uie lo� • <<�.ov: any r,reposed yraCing chan;:es <br /> • ExiSting a�d propo5ed utilitie5 • $how mrasurements � <br /> DO NOT WRITE 6[�OW THIS LINE O <br /> PERMIT CONDITIONS <br /> t.All calls for inspection shall be matle 24 hr^,,i�advanr.e-phone 259•8810. � <br /> 2.All work shall be performed in accordanc�wnh this permit and current Cily ot Everett Design and Conslruction <br /> Standards and Specifications. <br /> 3.Call Lor_ation Underground Service 48 hrs.belore you dig.TOLL FREE NUMBER 1-500•424-5555. � <br /> � <br /> ��UBL�C WORKS PERMIT � <br /> NOT REOUIRED � <br /> 9Y A <br /> i)ATE ✓� 3 � �% <br /> 1� <br /> AGKNOWLEDGEPdENT OF CCNDITIONS <br /> i�ti�r�r•tl�=rsi:med owner/appl�cant horztiy agrees ro hold anC sa•.e narm- <br /> - –�� dss �I•.�- Cdy o� EvereU trom any and .all daims lor damaqe�,. cos15. <br /> : e�Uenses o� r,auses of action that may arise because of �ns'a�:nt�en <br /> � -�- and ma�ntenanr.e n! ine imFrovement or olher ngt�}-of�wai use nNrelo <br /> I a;.phe�; (or and �urther agrees lo remove samr_ upon notice hom Ihe <br /> Approved for Construction Data �;;� ,��;h �n replace pubhc property damaged thereby. <br /> I <br /> i <br /> FINAL INSPECTION Date I <br /> Approved as Conslructed Siqnalure el Appficant Date <br /> �� PUBLIC WORKS DEPARTMEIJT WOP,K AUTHORI2ED 6Y THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CedarStreet 190 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett WA d6201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:259�8810 CANCELLED BY THE CITY UPON ANY STORPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAVS DURATION. <br />