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Date 10/10/94 <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only TO POSTING DEe 1 o tqm <br />Public Work* Permit e • � 86 / <br />Bldgpar y 9n <br />Pubbc Work* Fee s <br />Tolal Fee <br />Len AFee Paid f <br />Balance <br />Due i <br />0 34.30 .&`- - <br />-t- Tr'n fiKL I n. f, 9n -Io n <br />Harbor Mountain neve10 ant 2911 1/2 Hewitt Ave Everett 98201 258-9366 <br />Owner Malting Address City Zip Phone <br />Tim Hossner 223-1361 <br />Applicant Mailing Address City Zip Phone <br />Descrioe Proposed Work New retail/office building <br />CC'-07'.,,- tnr ,Ed TiSninas-TO/nf0 /O <br />Project Address (if known) / J /o <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: <br />• Property Lines <br />• Outline and dimensions of all existing and <br />proposed structures on the lot <br />• Existing and proposed utilities <br />C <br />• Centerline of street <br />• Indicate North <br />• Show any proposed grading changes <br />• Show measurements <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in advance- phone 259-8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424.5555. <br />¢, C�t/y'L 70 �e o%ne Ioe. Dolans aPProJ,02/96 1o:46an 000aa-7e7 <br />6y #00095486 <br />OTHES 8264.00 <br />PW/REV $436.72 <br />PW/INS $27219.50 <br />CHECK $3430.22 <br />Approved as Constructed <br />CLPUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone: 259.8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />H <br />IM <br />O <br />n <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City of Everett from any and all claims for damages, costs, <br />expenses, or causes of action that may arise because of installation <br />and maintenance of the improvement or other right-of-way use hereto <br />applied for and further agrees to remove same upon notice from the <br />City and to replace public property damaged thereby. <br />& 44L 14 M, <br />Signature Signature o�licant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />