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� C+1 � <br />��x <br />�Hy <br />y�� <br />� H .'��tl <br />�(�AM <br />x <br />o�d <br />��g <br />(aY (] <br />zH <br />i-+ <br />��H <br />g H <br />� C7 fA <br />G C <br />t� <br />HOCyi� <br />i q ' <br />� <br />ti <br />7 <br />:S <br />.� <br />:� <br />� <br />u <br />� <br />:i <br />:� <br />9 <br />;7 <br />��_ <br />� <br />Date� <br />ppplica('"�or <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />JON'S CONSTRUCTION 6912 220TH ST SW <br />.. . Mailina Addre: <br />vuobcNmnsPmmu. � <br />eiao.awi.• Q���A��� <br />r,. . <br />puC'icWo�xaFea f f <br />Toiai Fee <br />Leen apo� Fee PaiE 5�----- <br />6aianceDue S �' <br />Zip Phone <br />Describe Proposed Work TENANT IMPROVEMENT — <br />Pro;eclAddreSs(ifknown) '�' "" ���••�-- ---_— �- <br />Attach four(4) copies of Plans for Proposed work- Draw to scale and noteQ e enterline o( ��Peit able: <br />• Properly Lines • Indicate North <br />• Outline and dimensions ol all exisling and � ghow any proposed grading changes <br />proposed structures on the lot �$how measurements <br />O ExiSting and propOsed utilili?s <br />PERMIT CONGITIONS <br />1. All calls icr inspection shall be made 24 h•s. in advance - phone 259•8810. <br />2. All work shall 6e pedormed in accordanca with this permit and current City of Everelt Design and Constmctien <br />Standards and Specilications. <br />3. Call Location Underground�Service 48 hrs betore you dig. TOLL FHEE NUMBER 1•SO'0'424•55 . <br />�UF/�-�C. ' '� �> �,�.a/ �;,��. <br />��� . <br />ApprovedforConstruclion � Oate <br />FINAL INSPECTION Date <br />ppproved as Constructed <br />����PUBUC WORKS DEPARTMENT . . <br />3i00 Cedar Slreet <br />Everet4 WA 98201 <br />Phone: 2548810 � <br />/�' /.� <br />/:-ci�GC.liiial� / <br />' �O <br />/L _ j �� � <br />� <br />� <br />s <br />v <br />� <br />C <br />� <br />ACKNOWLEDGE�.NENT OF CONDITIONS <br />The undersic�ned owner/applicant ner^hy agrees to hold and save harr <br />less the City of Everetl trom any and all claims lor damag^s, cost. <br />expenses, or causes of action lhat may arise because of installatic <br />and maintenance of the improvomenl or other right•of-way use here! <br />applied lor and fuAher agrees to remove same upon notice trom th <br />City and lo replace puUllc properry damaged �hereby. . <br />Date <br />Signature of Applicant <br />WORK AUTHOR�ZED BY THIS PERMIT MUST P.c STARTED WITHI <br />180 DAYS OF DATE PERMIT IS ISSUED ANJ THEREAFTER IS T� <br />BE DILIGENTLY PURSUED TO COMPLETIO�J. THIS PERMIT MAY E <br />CANCELLED BY THE GTY UPON ANY STO�'PAGE OF WORK ON TH', <br />PROJECT tlVEH 90 DAYS �URATION. _: <br />. . . .- .-. . , ' ". �--_ .. , '-�..^^__'L':", Y <br />