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Date <br />AOG���ation Por <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Plen Check Nos <br />Owner �ppLLc�t.Datae <br />Job Addreee: <br />Ownar: <br />TenenG: <br />Propocod U�at <br />Applitent DBYC. Of No[ki <br />fi00D SNGP <br />H 38932 SEPA <br />1]/07/92 <br />881 OtYMPIC BLVD <br />AJW& ROBERT <br />SFH/SHOP <br />Describe Propose OFRICE SRT JOB 56T <br />�PPROVEO FOA PERMITs D11T6_/_/_ BY <br />P�olect AECress�il known� <br />,- <br />. ✓�ewcwen�v...n• <br />Bbp D�M • <br />w� wo...... s <br />ra�.� �» <br />i...�owr..>.e s <br />e.i.z•ow f � <br />Zip Phona <br />Attach lour (4) copies ol plan6 br proposeA woik � Draw to sca!e antl nole �he loilowinp aa appliwble: <br />• Property Llnae • Ccntedine ol atreel <br />• Outline ano dimensiona ol all eiistinq antl • Indicate North <br />proposed struclures on t�e lot • Show eny proDo�eO 9raainq c�enpes <br />• Eaislinq en0 proposed utlll�iea • Show meaeuremenis <br />PERMIT CONDITIONS <br />1. All calls tor Inspectlon snall be meae 2a hn. in aGvance • vhone 259•8810. <br />2. All wotk Bha110e pedormed In eccorCance wiM t�in cermit antl curtent Ciy ol Everett Deelqn entl CAnetmctlon <br />Standerda en0 Specilicatlona. <br />3. Gell Locatlon UnEerprounE Service 48 hrs belore you di4 TOLL FREE NUMBER 1•000�4'24•6555. <br />OP�oved lor Conslruction Oate <br />INAI INSPECTION Dele <br />ov�oveA ns Conslmcted <br />'`�PUBLI�.WORKSDEPAFTMEI,T <br />aPOo CeUar 5��eet <br />Everell, WA 98.01 <br />P�one:25B�B810 <br />PUOLIC WORKS PERMIT <br />NOT RE�Q,U�IRED � <br />flY___'L i��!/o <br />D 11T E f-i �=-- <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />H <br />N <br />� <br />O <br />� <br />Z <br />O <br />� <br />O <br />a <br />The unCerslpnetl owneqap0licant �ereEy eBrees �o holE anC save I+arm� <br />lesa the City ol Everett irom any an0 all claims lor Oamages, cost; <br />e�Denses, or causea ol ection I�al mey arise because ol installalion <br />anE main�enance ol Ihe imprpvement or olher riBhPo4wey use heret0 <br />ap01ie0 lor an0 lurther egrees to remove serce upan notice Imm Ihe <br />C�ty and lo re0�ace puDlir property damaped thereEy. <br />Signal�re o� Applicant �ale <br />WORK AUTHORIZE� BY THIS PERMIT MUST BE STARTED WITHIN <br />180 OAYS OF DATE PERMIT IS ISSUEO AND THEAEAFTER IS TO <br />BE DII.IGENTLY PURSUED TO COMPLETION. THIS FERMIT MAY BE <br />CANCELLED BV THE CITV UPON ANY STOPPAGE OF W08K ON THIS <br />PROJECT OVER 90 DAVS DURATIOv. <br />