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..�qq� <br /> � � � <br /> H <br /> Cp.'� H <br /> yy �n <br /> 4 <br /> � <br /> Hz � <br /> '� y� . � I <br /> � H � Date_�� , P�����wo��sP��m,�. <br /> y ~ ' Applir,a�ion For omn�cot . 9� 25975 , <br /> �y � PUBI_IC WORKS PERMIT P°°"a';�oo`°° s I <br /> I <br /> O H i�,s a,:m �x Pnm 5 I <br /> H � g o,�.,. ..�,�� s ! <br /> �" � Print or Type Only I <br /> y I <br /> 'Z H <br /> � H H General Nospital Pfedical Center 1321 Colby Ave Everett 93201 256-6300 <br /> � <br /> ~ O�vnnr Mailin9 Address Cip� 7ip Phone <br /> C� C7 ti <br /> �� t�7 Owner - <br /> x H f/� APPIiCanl Maitim'AddreSs Ci�Y Z�p Phonc <br /> HOfp <br /> oescribe aroposed work Tenant improvement - 6fedical Psychology 7lssoc. Office �� <br /> i <br /> � <br /> 'wject Address lil known) _].334_B2cke.f��er - rd�l. � I <br /> ,Uta�h four 1'1)copies of plans loi pioposed woik- Draw to scale and note ihe follovring as applicahl��. � i <br /> • Properly Lines • Centerline of streel ♦^ <br /> • Outline and dime�isions ol all existin9 and • Indicate Norlh V� <br /> proposed siructures on ihe lot • Sho���any proposed 9iaA:net<han9es <br /> � �- � � P Fxisting and proposed Wilihes • Show mc�suremenis w/� <br /> l �� W <br /> � DO NOT WFITE BELOW THIS LWF_ � <br /> 1 ' PERMITCONDITIONS <br /> � t..411 calls lor inspection shall bc made 24 hrs.in advance-phone 259•8810, � <br /> , � 2.All�vork shall 6e pedormetl in accordance wdh this permit and cunent City of Everett Design and Conslruclion <br /> �.�a Standards and Speaticalions. <br /> . 3.Ca�l Location Underground Service 48 hrs.belore you dig.TOLL FREE NUMBER 1•S00•424-5555. � <br /> � ` O <br /> i �� ^ . <br /> � <br /> / �' // <br /> , ��: CJoz�_ f�,12��,�r-./�o 7� .�-� y�L.ccn�r at' � <br /> � <br /> � Y/ <br /> !'�� //`'��CZ'.r'L. <br /> //_;f/-�'^ O <br /> __ a <br /> � <br /> �' <br /> ���� �CKNOWL[DGLCIEN�Of CONDITIONS <br /> Thc undetvqned o�vner/applir.anl herebY�9��es lo hold nntl save hann <br /> .. --- ---- .--.� � loss �hr CiIY �'f 6vcretl Irom any �nd all claims lor Aamages. cosla. <br /> r,ci.�nses. or causes ol �ction �hat may arise because ol installaUor� <br /> and maintenance ol Ihe imU�ovement or other n9hbol-way use hereio - <br /> apP����� �or and Iw�hcr ��recs lo iemove same upon nolice irom the <br /> �1Unwved lor Conslruc�ion Date City anA to �opl.•cc P���lic properry damae7ed Ihereby. <br /> FI?:AL INSPECTION Date — — <br /> ;�,pGruved as Constructed Siqnalw�of APPIicaM ��t° <br /> — 6NORK AUTHbRILflD BY THIS PERMIT MUST BC STARTED WITFIIDI <br /> i.�i.�iq� PUBLICWORKSDEPARTMENT 180 DAYS OF DATE P[RMIT IS ISSUED �ND TH[RFAFTER IS TU <br /> � 3200CedarSlreet 8[ DILIGENTLI' PURSUED TO CO�iFLf_TION 7HIS P[RAfIT F,1A1' HE <br /> Evcrett,WA9B201 CANGEi.LED BYTHE CITY UPON ANY StOf't'4GL �>FYJONI<<�N iili5 <br /> Phonc 259�8�10 PROJFJi O;ER 90 OAYS DUHAIION <br /> � <br />