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C�� <br />TYPE OR PRINT ONLY <br />Orvner <br />Applkant • <br />/ \ <br />PUBLIC �ORKS PERMIT °"°��� <br />Describe Proposed Work _ <br />PRWECT ADDRESS (if known) <br />PUBUC WORKS DEPAR7MENT Wblic Worka Pertnit N <br />3'200 Ceder Stieet <br />Ew�tt, WA 98201 259-8810 Buildfny P�rmR M <br />pubNc Worke Fes S <br />Plan Ch�ck Nos C 53815 88PA <br />11pp11cat.Datn: 12/20/96 <br />3ob IWdr���t 3210 W t4IJItILT60 BLVD �b <br />Own�r: STR7INNI(SAp G71RY <br />T�nant: <br />Propo��d U��s SINCLB FAMILY RBSIDSNCB <br />D��c. of Works Pha» r� <br />UPSTAIRS ADDN <br />O!lICS 86T JOB SET <br />APPROVED FOR P6RMITs DATS_/_/_ BY <br />Attach lour (�) copies of plens Ior propoaed work - Oraw to scale and note the fdbwing H epplicada: <br />�piopeAy Lines 'OutNne and dlmenaions ol all eaisting end p�oposed stiucNree on the bt 'E�cbtirp and propoaed utNkles <br />`Centerllne ot street 'Indieate NoAh 'Show anY ProPased 9radiny chanyes 'Show measurements <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours f� advance - phone 259-8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-8565. <br />� � �, � .,, <br />Approved for Conslructlon Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />� <br />O <br />� <br />� <br />O <br />a <br />ACKNOWLFDGEMENT OF CONDITIONS <br />The undersipned owrrer/applkant heruby agrssa to hokl and sevs hartMess <br />the Ciry ot Evarett hom any end all claims fa damges, coaU, ezpenses. or <br />causes of acUon ihat may erise beceuse of (nsUtlrtbn and maintenance ot <br />the improvement w other righl-of-way use hereto sppWd tor end furlfier eWees <br />to remove same upon notice fiom the Cily end ro npl�ee pubXc proprxty <br />dameged thereby. <br />Signature ol Appllcanl Date <br />WORK AUTHORRED BY THIS PEFMIT MUST BE STAHTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED ANO THEREAFfER IS TO BE DILIGENTLY PURSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CIlY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS WRATION. <br />