3212 NASSAU ST 2016-01-01 MF Import

� � TYPE OR PRINT ONLY --`oplication For PUBLIC 1�.ORKS PERMIT PUBLIC WORKS DEPARTMENT 3200 Cedar Street Everett, WA 98201 259•8810 oat� . 12/ 12/95 Public Works Permit A Building Pertnit N Public Works Fee $ PG1�'C/Pacific Campus 916 Pacific 98201 258-7123 Owner Mailing Address City Zip Phone Je:`f Moore 259-0868 Annf:cant Mailing Address City Zip phone Describe Proposed Work PROJECT ADDRESS (if known) Place Temp Modular for Job Shack 3212 Nassau Ariach four (4) copies of plans for propo,ed work - Draw to scale and nota the followinq H applicable: •Property Lines 'Outline and dimensions of all existing anc 'Centerline of street •Indicate NoAh •Show any prc DO Ni PERMIT CONDITIONS: 1. All cails for insper,tion shall be made ^e 2. All work sha!I be performed in accorde Construction Standards and Specifica 3. Call Location Underground Service 48 / �_--- - / V�S�.tJ�it/ �� ` � � i�%�� d -�-, � 3�/�= Approved for Construction Date FINAL INSPECTION Date Approved as Constructed IN171A� �KSpECt10N t�IRK BROOKS 2 - S_�_ � pATE � �� w �P�,�,t � U,�� Ilities )esign and DO-424-5555. � O ��/� V♦ O a , OF CONUITIONS � agrees to hold and save harmless s for damages, costs, expenses, or ............ ... .......... ...... ...... ......_ .,_____; of installation and maintenance o} the improvement or other right-of-way use hereto applied for and further agrees to remove same upon notica fmm the City and to replace public property damaged thereby. Signature of Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED ANU THEREAFfER IS TO BE DILIGENTLY PUHSUED TO COMPLETION. THIS PERMIT MAY EE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.