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� . - <br /> �ate ' Pu06c Works Permil s <br /> Application For em�.oam.+ <br /> PUBLIC VIlORKS PERMIT PueTolnlFeeFea S <br /> �eaa aooi Fee ae�e $ <br /> Balance Due $ <br /> Print or Type Only <br /> Plan Check No: B 37910ia'7f7G.•i37�I775EPA <br /> Applicat.Date: 09/01;92 <br /> Owner Job Addrese: 6133 LK CHAPLIN RD � Phone <br /> OwAEI: CITY OF EVERETT <br /> Tenant: WATER FILTRATION P7�ANT <br /> Proposed Uee: OFFICE <br /> Desc. of Work: <br /> Applicant ADDITION / ALTERATION — ADMIN OFFICES � Phone <br /> Describe Proposed Work _ OFFICE SET JOH SET _ <br /> APPROVED FOR PERMIT: DATE_/_/_ BY _ <br /> �� <br /> Project Address(if known) . �� <br /> Attach four(4) copies of pians for proposed work- Draw to scale and note tha following as applicable: . �A <br /> • Property Lines • Centerli�e of street ♦�� <br /> • Outline and dimensions of all existing and • Indicate North v <br /> prcposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements �� <br /> DO NOT WRITE BELOVJ THIS LINE �` <br /> PERMIT CONDITIONS <br /> � <br /> 1.All calls for inspedion snall be made 24 hrs.in advance•ph�ane 259-881 O. �+ <br /> 2.All work shal�be paAormed in accordance with this permit and current City of Everett Design:.nd Constructlon ♦ <br /> StanAards and Specifications. <br /> 3.Call Localion Underground Service 48 hrs.before you dig.FOLL FREC• NUMBER 5-800•424-5555. �S <br /> �� <br /> \I� <br /> � �v ��,,:�-,,.,.'( � �i� <br /> �ci ✓1' <br /> ��" _ <�- �� <br /> /Udt` ��'a����,:� <br /> ��. C) <br /> ic ?�' yZ �. <br /> — <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undereigned owner/applicaN hereby agrees to hold and save harm�� <br /> less the City ot Everett from any and all claims foi damxgas, costs, <br /> expenses, or causes of action �hat may arise because of inslallatie�n <br /> and maintenance of ihe improvemenl or other righFohway uee hereto <br /> applied for a,id further agrees to remove same upon notice from the <br /> Approved for Construction Date City and lo replace public property damaged thereby. <br /> fINAL INSPECTION Date Dale <br /> Approved as Cons!ructed Signature of Applicant <br /> ,����� PUBLIC WORKS DEPAFTMENT WOHK AUTHOFIZED BY THIS PERMIT tAUST BE STARTED WITHIN <br /> � 3200CadarSirent 180 DAYS OF DATE PERMIT IS ISSUFD AND THFREAFTER IS �TO <br /> � I BE DILIGENTLY PURSUED TO COMPLETION. THIS PERh11T MAV �E <br /> Everett,WA 98207 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON"fHIS <br /> Phone:259•8870 pROJECT OVER 90 DAYS DURATION. <br />