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[Cyq'� ro <br />C to <br />N <br />N i <br />K A <br />A <br />b N ro <br />B1 H <br />N H <br />to <br />O <br />H <br />M <br />H <br />r H <br />N <br />M <br />c N <br />t° rra <br />O Er. <br />C, <br />Date <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Plan Check No: B 36939 SEPA <br />Applicat.Date: 06/05/92 <br />Job Address: 505 EVERETT MALL WAY <br />Owner: ZAREMBA <br />Owner Tenant: JENNY CRIAG <br />Proposed Use: OFFICES <br />Desc. of Work: <br />TENANT IMPROVEMENT 2421 SF <br />Applicant <br />OFFICE SET <br />JOB SET <br />Describe Proposed Work APPROVED FOR PERMIT: DATE_/_/_ BY <br />Protect Address (it known; <br />Public Works Permit a <br />Bldg. DepL <br />Public Works Fee <br />Total Fee $ - <br />Less APPL Fee Paid $ <br />Balance Due $ <br />Phone <br />Zip Phone <br />Attach four (4) copies of plans for proposed work. Draw to scale and note the following as applicable <br />• Property Lines <br />• Centerline of street <br />• Outline and dimensions of all existing and <br />• Indicate North <br />proposed structures on the lot <br />• Show any proposed grading changes <br />• Existing and proposed utilities <br />• Show measurements <br />PERMIT CONDITIONS <br />1. All calls for Inspection shall be made 24 him 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 Specifications. <br />3. Call Location Underground Service 48 fire. before you dig. TOLL FREE NUMBER 1-800.424.5555. <br />Approved for Construction Dale <br />FINAL INSPECTION Dale <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone: 259.8810 <br />M <br />0 <br />n <br />z <br />0 <br />H <br />ch <br />0 <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <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 of action that may arise because of installation <br />and maintenance of the 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 Date <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 />