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Date <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />AppliCant <br />Describe Proposed Work <br />Project Address lif knownl <br />Plan Check No: B 49826 <br />Applicat.Date: 10/19/95 <br />Job Addre: 3715 OAKES AVE <br />Owner: EVERETT SCHOOL <br />Tenant: ADMIN OFFICES <br />Proposed Use: <br />Desc, of Work: <br />PLACE PORTABLE CLASSROOM <br />OFFICE SET JOB SET <br />PuObc Woixs Permit i _ <br />Bldq DeO�� � <br />PuphC WO�kS Fpp <br />Tolal:ee $ — <br />Less 400� Fec �aiC $ — <br />e.,i.,�« o�� 5 _ <br />SEPA <br />Phone <br />DISTRICT <br />Phon, <br />APPRVD FOR PERMIT: DATE_/_/_ BY <br />AttaCh four (4) copies ol plans br proposed work � D�av: to scele anA n��e tha 'oilowmg as apU�icabie: <br />• Property Lines <br />• Outllne and dimensions oi all existing and <br />proposed structures on the lot <br />• Existing and proposed utilities <br />• Centerline at streel <br />• Indicale Norih <br />• Show any proposed grading r.hanges <br />• Show measuremenis <br />PERMIT CONUITIONS <br />7. All calls for inspection shall be made 24 hrs. in advance- phone 259•881 O. <br />2. All work shall be pedormed in accordance with, this permit and current Ciry of Everett Design and Consirudion <br />Standards and Specificalions. <br />3. Call location Underground Servicc 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424•5555. <br />�'UQUC WOqKd PERNI• <br />RQF, qEQWRER <br />ti y�' _ / <br />tATE. ��l L4 9 S _ <br />�- <br />Approved lor Consiruction <br />�Dy�-��.6�es s/��L� /,�G <br />�/C / 6C, Ci� 7 /'O�^- /"OCFC'v'"�/ <br />� /��iniir r/n-., �� �7 � / <br />/ <br />ZO / / � <br />°S 2CCOI-..—cnpcn <br />/ � <br />Dale <br />FINAL INSPECTION � Date <br />Approved as Ccnslructed <br />���I�PUBLIC WORKS DEPARTMENi� <br />3200 Cedar Street <br />Evere�t, WA 98201 <br />Phone:259-8810 <br />ACKNOW�EDG[MENT OF CONDlTIONS <br />W <br />H <br />� <br />■ <br />� <br />O <br />a <br />The ur�.de�siqnetl owner/applicant hereUy agrees to hold and save harm� <br />less the Cdy of Everetl from any and all claims for damages. costs. <br />e<penses. or causes o� action that may aris= because ol insiallation <br />and main;enance o! �he irnprovement or other right-obway use hereto <br />appi�ed for and turiher agrees ro remove same upon notice irom ihe <br />Cdy and to replace pubhc property damaged therety. <br />SianaWre oi APPIiCant �ate <br />WORK AUTHORIZED BY TliIS PERMIT MUST BE STAnTED WITHIN <br />t80 DAYS OF DATE PERMIT IS ISSUED l�ND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPL[TION. THIS PERMIT MAY BE <br />CANCE�LED BY THE CITY UPON ANV STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DUR�TION. <br />