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h01ic Work�P�rmp• <br /> Date eiao.o.o�• <br /> Application For <br /> PUBLIC WORKS PERMIT `"°""'°"`°" <br /> ra,i►.. s <br /> lan ADW Fw Pak S <br /> Mynp Dw S <br /> Print or Type Only <br /> Plan Check Nos B 46761 SEPA <br /> Applicat.Date: O1/18/95 <br /> Job Addtei 931 PACIFIC AVE <br /> Owner: AGNOS PETER Z�P Phone � <br /> Owner Tenants <br /> Proposed Use: DENTAL OFFICE <br /> Deac. of Work: <br /> STAIR LANDINC ADDN 6 REMODEL OF STAIRS phone <br /> 2ip <br /> APPlicant <br /> OFFICE SET JOB SET <br /> OescNbe Proposed Work . APFRVD FOR. PERMIT: DATE_/,_I_ $Y <br /> W <br /> Project Address(N known) � <br /> Attach four(4)copies o(plans tor proposed work- Draw to scale and note�Ceo1'eWine ol stpeet�ble: � <br /> • Property Linea • Indicate NoAh <br /> • Outline and dimensions ot all existinp and � Show any proposed pradinq chanqes <br /> proposed atructures on the lot � ghoW measurementa M <br /> • Ezietiny and proposed utilitiea W <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CANDITIONS � <br /> 1.All calla for Intpedbn shall be made 24 hra.in advance-Dhone 259-881 O. <br /> 2,AO work ahall be peAormed�n accordance with thia permit end current Ciry oi Everett Deslpn and Const�uction <br /> Shrd�rds and SpecNlcations. � <br /> 3.Cell Lacation Underpround Servfce 48 hrs.before you dlg.TOLL FREE NUMBER 1$OG424'S55S• <br /> O <br /> � <br /> �UBLIC WORKS PERIdIT � <br /> NOf REQUIRE[� O <br /> �Y �B ' <br /> ��ATE / I/�� ' '� � <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/aOP���^�hereby aprees to hold and aave hum- <br /> less the City of Everetl Irom eny and all claims for damage0. costa. <br /> expenses, ar causes ol action that maY ariee because of inaldl�tion <br /> � and maintenance o� the improvemenl or other righFof•way use heroto <br /> applied lor and further agrees to remove same upon notice from the <br /> Approved for Construction Dale City and to rep�ace pubiic property damaged thereby. <br /> Dale Date <br /> FINAL INSPECTION Signature of Applicant <br /> Approved as Constructed WORK AUTHORIZED BY THIS PFRMIT MUST BE STARTED WITHIN <br /> � PUBLICWORKSDEPARTMENT 180 DAYS OF DATE PERM�T IS ISSUED AND THEP.EAFTER IS TO <br /> 3200 Ceder Slreet BE DIL�GENTLY PURSUED TO COMPLETION.THIS PERMI7 MAY BE <br /> Everett,WA 9Bz0� PROJECT OVER 90 DA S DUR T ON.STOPPAGE OF WORK ON THIS <br /> Phone:259•8810 <br />