Laserfiche WebLink
� � <br /> Date v�ak won.r.�n. <br /> Application For eiaa o•ot• <br /> PUBLIC WORKS PERMIT �°�W°�F� <br /> Tq.�F.. • <br /> Ln�hppt FN P�IC = <br /> Print or Type Only ��"`�o"• _ <br /> Plan Chock No: B 42790 s$pA <br /> Applicat.Date: 11/23 93 <br /> pW��� Job Addr�t 110i O S 1►V6 Phone <br /> Own�r= BDWINS DWIGHT & FRANCIS , <br /> T�nant: <br /> Propo�ad U�e: GARACS <br /> Appi�cant De�c. of Work: <br /> NEii DETACt1ED 6ARA68 Phona <br /> ! - Descdbe Proposed Work _ OFFICE SET JOB SET . <br /> � 11PPRVD !'OR PERMIT: D11TS_/_/_, SY <br /> � <br /> W <br /> � Prol�t Addresa(II known) � � <br /> - � AM�ch four(4)coplea o1 plana for proposed work-Draw to acele and note the followinB aa epplicable: � <br /> . • Property Linas • Centerl�ne of atreet � <br /> ! • Outline and dimensiona of dl eziatlny end • IndlcHe NoAh � - <br /> � proposed atructuroe on the lot • Show eny propoaed predinq chanqes . <br /> • Existinq and proposed utilitlsa • Show mesnurementa � , <br /> 1 DO NOT WRITE BELOW THIS LINE <br /> i PERMITCONDITIONS O <br /> 1.All c�lle for Inepection sh�ll be made 24 hra,in advenes•phone 2S�$810. � • <br /> � 2.All work eh�ll bs peAormed in accoMance with thla permit and current City of Everott Deaipn and Conatructlon <br /> ( Stendarda and Speclflcationa <br /> � 3.Call Locatlon Underqround 3ervice 48 hra.before you dlp.TOLL FREE NUMBER 1-800�4245555. � <br /> ? OPUBLIC WORKS PERMIT <br /> NOT EQUIRED � <br /> i <br /> BY B <br /> • DATE � <br /> O <br /> a ; <br /> ; <br /> ' ACKNOWLEDGEMENT Of CONDITIONS I� <br /> � The unde�siBned owner/applicent hereby aqrees to hold�nd save harm• <br /> • less the City of Everett from any and ell cleima for tlamayea, coata <br /> ; . expenses, or causes of action that may aAse becausa of inatallatfon <br /> end maintenence ol Ihe improvement or other ripht•ol•wsy uee herato <br /> ' epplied for and further agrees to remove seme upon notice irom the <br /> Approvad for Construction Date Cily and to replace public praperty dameqed thereby. <br /> FINAL INSPECTION Date <br /> � Approved as Constructed Signature ol Applicant Dale <br /> PUBLIC WORK9 DEPARTMENT H10RK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> � 3200CedarStreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS�TO <br /> Everet6 WA 98201 BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Phone:25&8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OP WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />