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i,^,l�:}.� <br /> ��,,�� Appliw�ion For / <br /> �i��_ P�BLIC WORKS PERMIT Date loi�i9� <br /> ��» �{ <br /> PUBLIC WORKS DEPARTMENT Public Works Permit q _ 1 S�_ <br /> 3200 Cedar Street <br /> Everett,WA98201 259-8870 1998 BuildingPermit# 56706 <br /> TYPEORPRINTONLY �� PO����G MAY `L� /� --- <br /> Public Works Fee 5��—T � �U <br /> T�ru�� �t,}— .{.80�- <br /> DPP INC 9333 NE 120TH ST �1201 KIRKLAND WAZ 98034 <br /> Owner Mailing Address Cit Zip Phone <br /> �ZS-346-s�z�� <br /> CH�VRON CONTACT: ROIiERT DOiJNING 334-8696 X248 <br /> Applicant PAailing Address City Zip Phone <br /> Describe Proposed Work CONVERT E7�ZSTING BANK TO GAS STARION CONVEIBNCE STORE ■ . ■ <br /> W <br /> . � <br /> � <br /> PROJECT ADDRESS(if known) 1020 SE EVERETT PtALt � <br /> Attach four(4)copies of plans for proposed work-Draw to scale and note the following if applicable: � <br /> •Property Lines •Outline and dimensions of all existing and proposed sirucWres on lhe lot •Existing and proposed utilities O <br /> •Centedine of street •Indicate North •Show any pmposed grading changes •Show mi�asurements � <br /> DO NOT WF,:i'E BELOW THIS LINE <br /> PEPMIT CONDITIONS: � <br /> 1.All cails for inspzction shall be made 24 ho�rs in advance- phone 259-8810. O <br /> 2.All work shall be pertormed in accordance with this permit and current City of Everett Design and <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> /—' . �SPWPI2�Nr cJ�-f-�d l/�3/`�8� o,-i�.-ve �.,4�:>�; � <br /> a ���-res <br /> E��:L� I.��J.V.'l. O <br /> �fii;HG 4e5"v <br /> �I 131940 • a <br /> in'�cfi 4Bu.COT�c. <br /> 9HG04 . <br /> �NFfi �1.�G �iw��S <br /> �'i.�/I;Vtd 106.�0 <br /> � ;;�INSF' bE6.00 <br /> y n7A� 31o3,5G <br /> I�N-iLi: ?].:`�.':0 <br /> A '?�i'_937 <br /> (M— ACKNOWLEDGEMENT OF CONDITIONS <br /> � The undersigned ownedapplicant hereby agrees to hold and save harmless <br /> / the City of Everett from any.;nd all claims for damages,costs,expenses,or <br /> � causes of action ihat ma arise because of installalion and maintenance of <br /> Appr d or Con � tion �e Y <br /> the improvement or other right-ot-way use herelo applied for and further agrees <br /> �� J� ,////I to remove same u nT tice from ihe City and to replace public property <br /> •/� �/7"�C � t<rL �-30� SR damaged lhereby. <br /> FINAL INSPECTION Date , <br /> Approved as Constructed / . / �� / / � <br /> Signature of Applicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER TO BE DILIGENTLY PURSUED TO <br /> COMPLEfION.THIS PERMiT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER DAYS DURATION. <br />