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Date <br />�`° <br />Application �or <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />� <br />Pubilc Wohs Pertnp + <br />amp. oeo� • <br />Pu011cWOASFee g <br />TOtal Fee <br />Lees Aool Fee Paltl $ <br />Balanca Due S <br />Plan C:heck No: B 27570 <br />Applicat.Date: 08/21/91 <br />Job Addrees: 505 SE EVERETT MALL WY STE 5 <br />Owner Sepa Number: Zip Phene <br />Owner: ZAREMBA GROUP <br />Proposed Uae: RETAIL <br />Deac. of Work: <br />TI – ADD PARTITIONS AND DOORS IN EXISTZNG <br />Applicant RETAIL SHOP 4475 SF OCCUPIED Zip Phone <br />� OFFICE SET JOB SET <br />Describe Proposed Woi AppROVED FOR PERMIT: DATE BY ' <br />—�—�— <br />Project Address (if known) <br />Attach four (4) copies of plans for proposed work - D2w to scale and note the following as applicable: <br />• Property Lines • Centerline of street <br />• Outline and dimensions of all existing and • indicate North <br />proposed stnictures on the lot • Show any proposed grading changes <br />• Existing and proposed utilities ' • Show measurements <br />PERMIT CONDITIONS <br />1. AII calls for inspection shall be made ^<4 hrs. in advance • phone 259•8810. <br />2. All work shall be pertormed in accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications <br />3. Cali Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 1•800•4245555. <br />Approved for Construction <br />�v �� r � `Uo,r ks �e,r►�,.� �. No�.., IZ�b. <br />�w,.s�w� �I�.�-- <br />�,-ZI -91 <br />Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />��MI�PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />EveretC WA 98207 <br />Phone:2538810 , <br />W <br />H <br />N <br />I- <br />V) <br />O <br />a <br />_:, <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less th2 City of EvereQ from any and all claims tor damages, costa <br />expenses, or causes of action that may arise because of installation <br />an�: maintenance of the improvement or other righhof•wey use hereto <br />auplied lor and further agrees to remove same upon notice from the <br />City and to replace puhlic proUerty damaged thereby. <br />Signature of Applicant Date I <br />WORK AUTHOflIZED BY THIS PERMIT MUST 9E STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO �', <br />BE OILIGENTLY PURSUED TO COMPLETION. TH{S PERMIT MAY BE �� <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS '�, <br />PROJECT OVER 90 DAYS DURATION. : <br />