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� <br />Application For <br />PUBLIC WQRKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 259-8810 <br />Date <br />Public Works Pertnit p <br />Building Permit 8 _ <br />TYPE OR PRINT ONLY Public Works Fee S <br />Owner Mailirn Plan Chec:: No: B 52250 <br />SEPA <br />Applicat.Date: 07/10/96 <br />3ob Addreas: 27b2 ROCKEFELLER <br />Owner: CENTRAL LUTHERAN CHURCH <br />Applicant Mailinc <br />Describe Proposed Work <br />PROJECT ADDRESS (if known) <br />Tenant: <br />Proposed Use: CHURCH <br />Desc. of Work: <br />RELOCATE WEST ENTRY <br />EXTERIOR WALLS <br />& COVER — t1SE EXISTING <br />OFFICE SET JOB SET <br />APPROVED FOR PERMIT: DATE_/�I� BY. <br />�hone <br />>hone <br />Attach four (4) copies of plans for proposed work - Draw to scale anC rote the tollowing if applicable: <br />•Property Lines 'Outline and dimensions ot all existing and proposed structures on the lot •Existing and proposed utilities <br />•Centerline of street •Indlcate North •Show any proposed grading changes •Show measurements <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 23 hours in 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•800-424-5555. <br />f UBLIC WORKS PEPMi� <br />PiOT EOUIRED <br />av.� -- <br />+��TE % // 96 <br />/' --- <br />Approved for Constructlon Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />W <br />� <br />� <br />N <br />m <br />O^ <br />♦ <br />� <br />O <br />� <br />N <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby ag2es to hold and save harmless <br />the City of Everett lrom any and all claims for damages, costs, expenses, or <br />causes of action that may arise because of installation end maintenance of <br />the improvement or other right•of-way use hereto applied for and further agrees <br />to remove same upon notice from the City and to replace public property <br />damaged thereby. <br />Signature of Applicant Date <br />WORK AUTHORRED BY THIS PERMIT MUST BE STARTED WITHIN 790 DAYS OF D�TE PERMIT IS ISSUED AND 7HEREAFfER IS TO BE DILIGENTLY PUPSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE Of- WORK ON THIS PROJECT OVER 90 DAYS DUPATION. <br />