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F n H <br />Ctl hC <br />as <br />r <br />F r-3 0 <br />HEXH <br />h: O <br />H '.it <br />0 H Q <br />Vn N <br />O E <br />r3 t7 <br />0 0 <br />yH <br />t" H I <br />F-t' H <br />Gr <br />N <br />C] Cf N <br />Z N rn <br />,90Cn <br />i �O <br />Date 2 26 91 <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />F obit. Works Perralt e Bldg Deal Deft. a 91 26549_ <br />Public Works Fee $ <br />Total Fee <br />Less ApPL Fee Paid S. <br />Balance Due a, <br />Deb Shops Inc. 9401 Blur ;rass Rd Philadelphia PA 19114 (215) 676-6000 <br />Owner Mailing Address City Zip Phone <br />Friedman Const <br />Applicant Mailing Address City Zip Phone <br />Describe Proposed Work Tenant Improvement <br />Project Address (if known) <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: <br />• Proparty Lines • Centerline of street <br />• Outline and dimensions of all existing and • Indicate North <br />proposed structures on the lot • Show any proposed grading changes <br />• Existing and proposed utilities • Show measurements <br />PERMIT CONDITIONS <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 City of Everett Design and Construction <br />Standards and Spedfications. <br />3. Call Locaticn Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800.424.5555. <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />everett PUBLIC WORKS DEPARTMENT <br />3200 Ceder Street <br />Everett WA 98201 <br />Phone: 259.8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />0 <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City of Everett from any and all claims for damages, costs, <br />expenses, or causes cf F,ction Cat may arise because of Installation <br />and maintenance of toe improvement or other right-of-way use hereto <br />applied for and further agrees to remove same upon notice from the <br />City and to replace public property damaged thereby. <br />Signature of Applicant Dale <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />