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Date <br />� <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Pu01ie WorMa ParmX f <br />Bbp. D�01. � _ <br />a�eiK won. F« <br />To1N Fw s <br />Lan �DM Fn P�iO i <br />8�4nn Dw i <br />Plen Check No: H 38880 SEPA <br />Applicat.Date: 12/02/92 Phone <br />Owner Job Addrs: 2604 ROCKEFELLER <br />Owner: GTB NORTHWEST INC � <br />Tenant: <br />Propoeed Uee: T6L6PHONE SWSTCHING OFFICE <br />Applicant Deec. of WOrk: Phone <br />T.I. — 4 FLOORS AT 58485F PER FLOOR <br />Deacribe Proposed Work _ OFFIC6 SET JOB SET <br />11PPRVD FOR P6RMITi DATE_/_/_ gy � <br />Pro�ect Addresa (If known) <br />Attach four (4) copies of plans fur propoeed work - Draw to �^ale and note the following as applicable: <br />• Property Linea • Centerline ol street <br />• Outline end dimenalons of ell exletinq and • Indicate North <br />propOsed atructutes onthelot • Show any proposed gradinp chanqes <br />• Exiatinp and propoaed utllities • Show meaaurementa <br />Approvetl for <br />PERMIT CONDITIONS <br />1. All ulls for Inapedion shell be metle 24 hra In advenee • phone 259$810. <br />2. All work �h�ll bs peAormed In accordance wNh this permit and current City at Everett Desipn and Constructlon <br />Standards md SpeciHcetlona <br />3. Call Locetion Underpround 3ervice 48 hrs. before you dip. TOLL FREE NUMBER 1•80o-4245555. <br />PUBI.IC 'WORKS PERMIT <br />NIO�T REOUIRED <br />BV �/ <br />DATE � 2 =� 5 2 <br />Date <br />FINAL INSPECTION Date <br />Approved as Conslrucled <br />PUBLIC WORKS DEPARTMENT <br />3200 Ceder Street <br />Everett, WA 98201 <br />Phone:259•BB10 <br />ACKNOWLEOGEMENT OF CONDITIONS <br />W <br />H <br />� <br />� <br />O <br />� <br />� <br />� <br />a <br />The undersigned awner/applicant hereby epreea to hold end save harm- <br />less the City of Eveiett from any end all cleims for demeges, costs, <br />expenses, or ceusas of action that mey erise because of Instellation <br />and maiMenence of the improvement or other Aqht-o1•wuy usa hereto <br />applied for and further agrees to remove same upon notice (rom the <br />City and to replace public property demaped thereby. <br />Signelure ol Applicant Dale <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 />