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� i <br /> I <br /> � <br /> _ �ti�til�+� P�o�,<,•,e,.,P»,m.,. � <br /> ' DatB - eiaa.o�oi.+ <br /> �� ppplication For <br /> PU�LIC 'WORKS PERMIT P���rcWar�sF^e <br /> Total Fee 5 <br /> � Lesf<OC�F<0 P3iE 5 <br /> - BamnceDuo S <br /> ��� Print or Type Only <br /> A77x � Plan Check No: B 28x37 SEPA <br /> a y y . Applicat.Date: 11/19/91 Zip Phone <br /> : Owner Job Addra: 5108 EVERGAEEN WAY $2 <br /> H �� ? Owner: HARBER G <br /> H H 7 Tenant: PIZZA TIME <br /> FC y� � Proposed Uee: RESTAURANT <br /> O x0 � Applicant Desc. of Work: Zip Phone <br /> ..� y H ; CHANGE OF BUSINE55 - REPAINT� NEW TILE� <br /> BUILD FRONT COUNTER <br /> H z3 � <br /> O y� 5 Describe Proposec OFFICE SET J08 SET <br /> a APPRVD FOR PERMIT: DATE_/_/_ 8Y <br /> ��g � <br /> zH� ; - _ � <br /> H <br /> H y 'i Prolect ACdress(if known) I <br /> g � � <br /> � Attach tour(4)copies of plans for proposed work•Draw to scale and note the lollowing as applicable: � <br /> O Cy C~/� � • Property Lines • Centedine ol street <br /> • Outline and dimensions oF all ezisting and • Indicate North <br /> �j �� S proposed siructures on the lot • Shew any proposed grading changes <br /> � y f/) � • Existing and proposed utilities • Show rr,easuremenis � <br /> H O V1 i <br /> �� t �- DO NOT WRITE BELOW THIS IINE � <br /> i <br /> � PEFMITCONDITIONS � ! <br /> ` 1.All calls lor inspectlon shall 6e made 24 hrs.in advance•phone 259•8810. �, <br /> ; 2.All work shall be peAo�med in accordance wilh this permit and current City ol Everett Dosign and Canstruction � i <br /> l <br /> �i � Standards and Specificatlons. <br /> �y`' � 3.Call Locatlon Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800-424•5555. � �� <br /> I �+ � L�l p' . � <br /> � '� �lJ:Ge�2' LtJUzI�- �O;�nwu^ /ZvY�� /���uev-e� . I \ <br /> !m r' � �Q � <br /> I �� .i <br /> :� <br /> ' _; I/-GD-9/ �. <br /> i � � : <br /> �� � i <br /> n � .• rllt I� <br /> o—.�" .j <br /> � � , <br /> � <br /> � <br /> ' g"'�! " � � ACKNOWLEDGEMENTOFCONDITIONS <br /> p <br /> � licant hereby agrees to hold and save hanr <br /> ,� The undersi9ned owner/app' <br /> � less ihe Cily ol Everett from any and all claims for damages, cosL <br /> � ezpenses, or causes of action lhat may arise because of installatio� <br /> � � ' . . � and maintenance ol the improvement or other right•of�way use hereb <br /> _ app��ed tor antl fuAher agrees to remove same upon notice Irom th� <br /> V - Approved(or ConsirucUon Date Ciry and to replace pu6lic property damaged thereby. <br /> `� t <br /> '? Date Dat? <br /> FINAL INSPECTION Signature of Applicanl <br /> � ApVroved as Constructed yyORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHII <br /> " PUBLICWORKSDEPARTMENT 7B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS T� <br /> .' ��r� 3200 Cedar Sireet BE DILIGENTLY PURSUED i0 COMPLETION.THIS PERMIT MAY B <br /> Everel4 WP.9B20� CANCELLED BYTHE CITY UPON ANY STOPPAGE OF WORK ON THI <br /> Phone:259•8870 PROJECT OVER 90 DAYS DURAT�ON. <br /> , _ .. __.__ . ..______.____�... _ , J <br />