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Date <br />Application For <br />PUBLIC WORKS P�RMIT <br />Print or Type Only <br />Plan Check No: B 42265 SEPA <br />Applicat.Date: 10/O5/93 <br />Job Addresa: 620 SE EVERETT MALL WAY <br />Owner Owner: HILLIS LARRY <br />Tenant: ARCT7C WINDOWS <br />Propoeed Use: RETAIL <br />Deec. of Work: <br />TENANT IMPROVEMENT <br />Appiican� <br />OFFICE SET JOB SET <br />D=scribe Proposed Work . APPROVED FOR PERMIT: DATE_/_/_ BY <br />Project Address (if known) <br />,-- <br />Zip <br />Atlach four (4) copies of plans (or proposed work - Draw to scale and note the following as applicabie: <br />• Property Lines <br />• Outline and dimensions of all existing and <br />proposed strucWres on the lot <br />• Existing and proposed utilities <br />Public Worka Pormit r <br />BItlB� pe0�.+ _ <br />PuClit Works FBB <br />TotelFea $ <br />Les9 ApO� Fee FaiC $ <br />Ffeiance^ue $ <br />• Centerline of street <br />• Indicate North <br />• Show any proposed grading changes <br />• Show measurements <br />Phone <br />Phone <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 fn accordance wilh lhis permit and wrrent Ciry of Everett Design and Constructlon <br />Standards and Specificatlons. <br />3. Call Location Under�round Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800•424-5555. <br />PUBLIC WORKS PEqMIT <br />NOT REOUIREO <br />BY ` � <br />DATE ) 9 3 <br />Approved for Construction <br />FINAL INSPECTION <br />Approved as Constructed <br />�ArI�PUBIIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everelt, WA 98201 <br />Phone:259-8810 <br />Date <br />Dale <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />H <br />� <br />� <br />� <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City ot Everett from any and all claims for damages, costs, <br />expe^ses, or causes of action that may arise because o( installation <br />and maintenance of the improvement or other right-of•way use hereto <br />applied tor and furiher agrees to remove sar�ie upon notice from the <br />City and lo replace public property damagad thereby. <br />Signature of Applicant Dale <br />WORK AUTHORIZED BY TtIIS 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 />