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TYPE OR PRINT ONLY <br />Ownx <br />Applkant <br />Describe Proposed Work <br />PUBLIC '. ORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />9200 Cedar Street <br />E��� WA 88201 259•8870 <br />Plan Check No: <br />Applicat.Date: <br />Job Addreea: <br />owner: <br />Tenant: <br />Propoeed Use: <br />Deac. of Work: <br />CONSTRUCT NEW <br />B 51144 SEPA <br />03/20/96 <br />25b1 HARRISON AVE <br />TULLER CONNIE <br />SHOP/STORAGE <br />SHOP <br />OFFICE SET JOI; SFm_ <br />APPROVED FOR PEAMIT: DATE_/_/_ BY <br />PROJECT ADDRESS (if known) <br />Da� <br />Publk Vyorks pertnn N <br />Building p�� K <br />Publk Works Fee S _ <br />Fhone <br />Phone <br />Attech four (4) � a� py�y ���� �� _�W to scale and note the folbwinq M applicable: <br />��Y ��es 'Outline end dlmenabna of all existing and propoyed rtruetures on the lot •Ezfsting and proposed util0ks <br />'CentMine of street 'Indkate North 'Slpw eny prop�� g�tling changes �Show measuremeMy <br />PERMIT CONDITIONS: "" ""' •�ni � c ocLV W I F115 LINE <br />1. AII calls for inspection shail be made 24 hours in advance - phone 259-8810. <br />2. All work shall be peAurtned �n accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Locatfon Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555, <br />PUBLIC WORKS PERM1' <br />NOr REOUIRER <br />8Y� <br />i�ATE.�-� a� 9G <br />- - ��. <br />�� <br />APP�"ed for Constructlon Date <br />flNAL INSPECTION Data <br />APP��ed as COn81NCfed <br />������.`��zrt:��- <br />�� /Lev, sc„-d .S�c� Se..�;-c� <br />7�'1 tt.�i'�a-L� -�� ��'�- �Oh o�10S.-c( <br />/�,�(��.�r !!i"L 2 Sc-01c� Sec�..�it— <br />bi' <br />// �,i7�� ` ���/ LLL� �4'/'pzK•.`O <br />/2L �c,lc�iu� . <br />W <br />� <br />� <br />� <br />� <br />� <br />O <br />a <br />ACKNOWLEDOEMENT OF CONDIiIONS <br />The undersfgned owner/aippllcA�� he�yY e0�y �a ��d and sava harmyay <br />the City of Eveietl from any anA all claims for demages, costs, ezpe�yea� a <br />causes of aqion that may arise yece�ae of instellatlon and maintenance ot <br />Me improvement or oMer right-ol-way usa herMo applied faa�d further apreey <br />to remove same upon notice hom the Ciry and to replaca public po <br />damaged thereby. �Y <br />� Signatureotqpplicent <br />WORK AUTHORIZED BY h11S PERMIT MUST BE STARTED WIT}{�N 780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFiER IS TO BE DILIGENTLY PURSUED TO <br />COMPLEf10N. hIIS PERMIT MqY BE CANCELLED BY THE CITY UPON ANY STOPPqGE OF WORK ON THIS PRQIECT OVER 90 DAYS DURATION. <br />