Laserfiche WebLink
Date — <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Owner <br />Applicant <br />Plan Check No: B 41628 SEPA <br />Applicat.Date: 08/10/93 <br />Job Address: 2822 HOYT <br />Owner: RUBATINO REFUSE <br />Tenant: <br />Proposed Use: COMMERCIAL RENTAL <br />Desc. of Work: <br />BUILDING REHABILITATION <br />Describe Proposed Work _ OFFICE <br />Project Address (if known) <br />JOB SET <br />APPRO"ED FOR PERMIT: DATE_/_/_ BY <br />Public Worts Pertell <br />Bldg Dept. <br />Public Works Fee <br />Total Fee <br />Less Appl Fee Paid $ <br />Balance Due $ <br />Attach four (4) copies of plans for proposed work - Draw 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 structures on the lot • Show any proposed grading changes <br />• Existing and proposed utilities • 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 in accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Undergiound Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800.424.5555. <br />PUBLIC WORKS PERMIT <br />NOT REQUIRED <br />8Y <br />t DATE <br />t; ? SIN PEC ON <br />K\BR OKS ' <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />C� <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone: 259.8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />r <br />Cl/ <br />ca <br />0 <br />Z <br />0 <br />FM <br />Cl) <br />0^ <br />an <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 />