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Date <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Owner <br />Plan Check No: <br />B 36952 SEPA <br />06/08/92 <br />Applicat.Date: <br />Job Address: <br />1402 SE EV WAY <br />Owner: <br />Tenant: <br />TITANIC CORP <br />GENERAL NUTRITION CENTER <br />Applicant <br />Proposed Use: <br />RETAIL <br />Desc. of Work: <br />TENANT IMPROVEMENT <br />Describe Proposed Work _ <br />OFFICE SET <br />JOB SET <br />APPROVED FOR PERMIT: DATE_/,_,/_ BY <br />Project Address (if known) <br />Public Worn Permit a <br />Bldg. Dept <br />Public Worn Fee S, <br />Total Fee <br />Less Appt Fee Paid $ <br />Balance Due $ <br />Zip Phone <br />lip Phone <br />f II in as applicable: <br />Attach four (4) copies of plans for proposed work- Draw to scale and note the <br />Centerline of street <br />• Property Lines <br />• Outline and dimensions of all existing and <br />• Indicate North <br />• Show any proposed grading changes <br />proposed structures on the lot <br />• Show measurements <br />• Existing and proposed utilities <br />�eas1 PERMIT CONDITIONS <br />I.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 />'ser' Standards and Specifications. <br />3. Call Location Underground Service 48 him before you dIg.TOLL FREE NUMBER 1.800.424.5555. <br />arise <br />6 <br />'are1 <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />IPM77PUBLIC WORKS DEPARTMENT <br />3200 Ceder Street <br />Everett WA 98201 <br />Phone: 259.8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />IME <br />CIO <br />W <br />0 <br />Z <br />0 <br />V♦ <br />0 <br />a <br />The undersigned ownerJapplicant 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 of action that may arise because of installation <br />and maintenance of the Improvement or other rightof-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 ApplicantWORK AUTHORIZED BY THIS Date <br />STARTED <br />IN <br />180 DAYS OF PERMIT <br />DATE PERM T ISSSUED AND THEREAFTER HEREAFTER 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 />