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Dete _ % ,{ wekwo,..rnm�u _ <br /> Apo�icallon For � eap o.o�• <br /> PUBLIC WORKS PERMIT a°;;;::`•• , <br /> �.uew�rurna� <br /> Print or TYPe Only e.a.�.o�. f <br /> Ownar Plen Check No: B 39818 56PA <br /> A p1Scet.Dsta: 03/09/93 P�one <br /> pJob Addreees 616 PECKS OA <br /> Owner: EVERETT SCHOOL DISTAICT <br /> Tenant: MADISON ELEMENTAAY <br /> ppp�{�g�� Ptopoeed Ueet PORTABLE P�one � <br /> D9ec, oE Mork: � <br /> ONE POATABLE CLASSROOH <br /> Desctibe Proposetl Wark i <br /> OFFICE SET JOB SET <br /> APPROVED FOR PERMIT: DATE_/_/_ BY � <br /> _ i <br /> W <br /> Projec�Atltlresa(il knOwn) L <br /> At�aC�lour(4)Ca0ie9 0l plans lor proposetl wo:k•Oraw�0 6Cale antl noie Ine IOIlowing as appliCable: � <br /> •Properry Lines •Cmtedine a:streel /w <br /> •Outline an0 Cimensions ol all existing antl •InEicale North V, <br /> proposetl SlmCtures on Ihe lol •ShOw any proposed gtatll:y Cl:anqe5 <br /> •Exisling anA proposatl utililics •Show measurements � <br /> DO NOT WRITE BELOW THIS IINE O <br /> PERMIT CONDITIONS <br /> t.All calls tor inspectbn s�all be maan 2a hrs.in aEvance•phone 259-8870. � <br /> 2.All work shall be perlormed In eccortlanca wit�this permit antl currenl City ol Everelt Design end Construcllon <br /> Slentlartls antl Spttillcalions <br /> 3.CaIl�ocatlonUndergrountl5ervica4Phnbetoreyroutlig.TOLLFPEENUMBERI-800�424•$$55. � <br /> O <br /> PUB�IC WORKS PERMIT � <br /> NOT qEpUIqEU � <br /> BV_�9 <br /> DATE�� Q <br /> a <br /> ACNNOWLEDGEMENT OF CONDITIONS <br /> T�e undCrSigneC owner/ap0��tant hefeCy aBrees IC hold An0 9ave harm• <br /> less Iho Cily ol Everelt Iwm eny anC all �lalc:� lor Eamages cOSIS <br /> oapense; or causes ol action Ihat may:��r+ becausu al Inslnllallon <br /> and mainlener.ce ol t�e improvemenl or oiher iiB���=��M'ay use herelo <br /> opplicd lor anC Nrlher aQrees lo remove sa;.re dpon notice Irom t�e <br /> ppmved lor Constmctlon Date Cily anE�o�epiace puElic v�oputly tlamaqeE IhereOy. <br /> NAL�NSPEC7IPN Date <br /> provvd as Conslmcted Sipnalure ot AOPllcant Onte <br /> PUBLIC\YORNSDEPnRTMENT WOflK AUTHORIZED BY TNIS PERMIT MUST BE STARTED WIiHIN <br /> 3200Cetlar5lraet IBO OAYS OF DATE PERMIT IS ISSUED ANO THEREAFTER IS TO <br /> Everett,WA98Y01 BE DILIGENTLY PURSUEO TO COMP�ETION.THIS PEPMIT MAY BE <br /> Phona:259�B8f0 CANLELLED BY THE CITV UPON A�Y STOPPAGE OF WOAK ON THIS <br /> PROJECT OVER 50 DAY$DURATION. <br />