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Date <br />Application For <br />PUBLIC WORKS PERM� i <br />Print or Type Only <br />Owner <br />Applicant <br />Describe Proposed Work _ <br />Project Address (if known) <br />Plan Check No: B 416�7 <br />Applicat.Date: OS/10/93 SEPA <br />Job Addrs: 2818 HOYT <br />Owner: RUBATINO REFUSE <br />Tenant: <br />Proposed Use: CON.MERCIAL RENTAL <br />Desc. of Work: <br />BUILDING REHABILITATION <br />OFFICE SET_��JOB SET <br />APPRVD FOR pERMIT: DATE_�_�� BY <br />Attach lour (4) copies of plans for proposed work - Jraw to scale and note the following as applicable: <br />• Property Lines <br />• Outline and climensions of all existin,y and <br />proposed sVuctures on the lot <br />• Existing and proposed utilities <br />i� �/� <br />,' <br />ruo�ic wo�b peimii . <br />aiag. oeu�.• <br />PUEI�c Wo�ks Fee <br />To�al!ee S � <br />Lesa AppL Fee Paia g <br />ea�a��a o�� s <br />• Centerline ol street <br />• Indicate Norih <br />• Show any proposed grading changes <br />• Show mezsuremen!s <br />Phon� <br />Phone <br />PERMIT CONDITIONS <br />1. All calls for inspection shall Fe made 24 hrs. in advance - phone 259•8810. <br />2. All work shall be pedormed in arcardance wi!h this permit and current Ci�y of Evere�l Design and Construdion <br />Standards and Specificahons. <br />3. Call Locatior� Under{�round Ser�i^e 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424•5555. <br />PUBLIC WORKS PERAAIT <br />NOT REOUIRED <br />BY ��' <br />DATE � " "= <br />Approved for Canstruction Dale <br />FI�AL INSPECTION D:�te <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everetl, WA 98201 <br />Phone: 259-9810 <br />ACKN01h'LEDGEMENT OF CONDITIONS <br />� <br />�i <br />• <br />� <br />� <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less ihe City of Everett from any and all clairns lor damages, costs, <br />expenses, or wuses of action that may arise because ol in,tallation <br />and maintenance of ihe improv�ment or olher right-oFway use hereto <br />app!ied for and further agrees to remove same u�on notice Irom the <br />Ci1v and to replace public property damaged thereby. <br />S;y^alure ol Applicant Date <br />WORK AUTNORIZED BY THIS PERMIT MUST �E STARTED WITHIN <br />780 [�4YS OF DATE PERI��IT IS ISSUED AND THEAEAFTFR IS �TO <br />Be DILIGENTLY f'URSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITl' UFON ANY STOPPAGG nF WGRK ON THIS <br />PROJECT OVER 90 DAYS GURATION. <br />